Fetuin-A and Hemogram-Related Inflammatory Markers in type 2 Diabetic Retinopathy

Diabetic retinopathy (DR) is considered a microvascular complication of diabetes mellitus (DM) and is characterized clinically by progressive alterations in the microvasculature that result in retinal ischemia, neo-vascularization, altered retinal permeability and macular oedema. DR is currently considered a leading cause of blindness in the adult population. Fetuin-A is a multifunctional glycoprotein that could be an early initiator of DR pathogenesis due to its dual role in insulin resistance and angiogenesis. This study aimed to evaluate the level of Fetuin-A as well as CBC parameters and its related inflammatory markers in DR patients as markers that may help to predict the disease occurrence and may help to follow up and avoid complications along the disease course. A case-control study enrolled forty-five participants selected from Al-Zahraa University Hospital, between March 2021 and October 2021, they were divided into three groups; group I; control group (n=15) non-type 2 diabetic persons who appeared to be healthy, group II; type 2 diabetic patients without DR (n=15) and group III; type 2 diabetic patients with DR (n=15). All groups were age and sex-matched and were investigated by ELISA to evaluate the serum level of Fetuin-A, besides CBC parameters and its related inflammatory markers. Comparison study shows; a non-significant increase of Fetuin-A value (P=0.539), a significant increase of diabetic duration (P=0.041), a significant decrease of PLR (p=0.019), as well as significant decrease of NLR (P=0.041) in the group of diabetic retinopathies compared with that without retinopathy. Although there is non-significant increase of Fetuin-A value in the diabetics with and without retinopathy compared with that in the non-diabetics, there is a significant negative correlation between Fetuin-A value and RDW% in the apparently healthy group (0.03). There is highly significant negative correlation between FBG and HCT% (P=0.001), significant positive correlation between 2HPP and LMR (P=0.002), significant positive correlation between HbA1c and LMR (P=0.030), as well as significant positive correlation between 2HPP and diabetic duration(P=0.031) in the diabetic retinopathy group. There is a significant negative correlation between diabetic duration and HCT% (P=0.043) in the diabetics without retinopathy. Diabetes type 2 retinopathy is a complication of a sophisticated diabetic disorder associated with a state of immunodeficiency, systemic inflammation and anemia that need to be investigated beside the glycemic markers and diabetic duration to avoid serious complications. Fetuin-A has no significant role in the pathogenesis of diabetic retinopathy, yet it may have a role in RBCs development and maturation.