Association of plasma fibrinogen level and blood pressure with diabetic retinopathy, and renal complications associated with proliferative diabetic retinopathy, in Type 2 diabetes mellitus

Aim To clarify the association of several clinical parameters, including pl asma fibrinogen level, with diabetic retinopathy in patients with Type 2 di abetes mellitus (DM). Methods A total of 294 Japanese patients with Type 2 DM were studied; 53 pa tients with no diabetic retinopathy (NDR), 90 with background diabetic reti nopathy (BDR), and 151 with proliferative diabetic retinopathy JPDR). Multi ple logistic regression analysis was performed to assess variables independ ently associated with diabetic retinopathy in two settings: presence of ret inopathy of any severity and presence of advanced retinopathy. Results The following parameters were identified as independent factors ass ociated with the presence of diabetic retinopathy (NDR vs. BDR+PDR): type o f therapy (P<0.0005), log-transformed plasma fibrinogen level (P<0.05), mea n blood pressure (P<0.05), and duration of diabetes (P<0.05). The independe nt variables associated with advanced retinopathy were type of therapy (P<0 .00005), age (P<0.0005) and nephropathy (P<0.05). Body mass index, smoking and hypertensive status, HbA(1c) and total cholesterol levels were not inde pendently associated. Conclusions These data suggest that in patients with Type 2 DM, an increase d blood viscosity due to high fibrinogen level as well as an elevated intra vessel pressure play a role in the development of diabetic retinopathy, and that the progression to PDR is influenced or accompanied by the deteriorat ion of renal status.