erum laminin a a marker of diabetic retinopathy development: a 4-year follow-up tudy

PURPOE: The uefulne of laminin a a erum marker of diabetic retinopathy i a topic that generate conflicting view. The aim of the preent tudy wa to invetigate the effect of diabetic retinopathy on erum laminin-P1, the larger pepin reitant fragment of laminin, and to elucidate whether erum laminin-P1 could be an indicator of the rik for development of diabetic retinopathy. METHOD: In a propective tudy, 97 conecutive diabetic patient (35 type 1 and 62 type 2) without diabetic retinopathy and a urinary albumin excretion rate lower than 20 μg per minute were enrolled in a 4-year follow-up tudy. Patient who developed microalbuminuria during the tudy were excluded in order to avoid the influence of diabetic nephropathy on erum laminin-P1. At the end of follow-up, data from ophthalmologic tudie and erum laminin-P1 were evaluated in the 66 normoalbuminuric diabetic patient who completed the tudy. REULT: No tatitical difference were oberved in baeline laminin-P1 erum concentration between patient who developed diabetic retinopathy (n = 15) and patient who remained without it during follow-up (n = 51). However, erum laminin-P1 level obtained at the end of the tudy were ignificantly higher in patient who developed diabetic retinopathy (1.75 ± 0.33 U/ml veru 1.47 ± 0.27 U/ml; P = .002). Furthermore, tatitical difference wa oberved when initial and final value of erum laminin-P1 were compared in patient who developed diabetic retinopathy (1.56 ± 0.27 U/ml veru 1.75 ± 0.33 U/ml; P = .001). Remarkably, an increae in erum laminin-P1 concentration wa detected in all but two of the patient who developed diabetic retinopathy. The relative rik of development of diabetic retinopathy in patient who howed an increae in erum laminin-P1 during follow-up wa 5.4 (95% confidence interval, 1.32 to 22.13). CONCLUION: erum laminin-P1 i a marker and a rik indicator of diabetic retinopathy but i not an early predictor of it development.