TY - JOUR
T1 - Inflammatory biomarkers as prognostic tools for diabetic retinopathy progression
T2 - a prospective study
AU - Johansen, Mette Skov
AU - Stidsen, Jacob Volmer
AU - Hansen, Aleksander Lühr
AU - Johansen, Torben Skov Dyg
AU - Nielsen, Jens Steen
AU - Pedersen, Frederik Nørregaard
AU - Grauslund, Jakob
AU - Olsen, Michael Hecht
AU - Højlund, Kurt
AU - Olesen, Thomas Bastholm
N1 - Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.
PY - 2026/5
Y1 - 2026/5
N2 - AIMS: This study aimed to evaluate the prognostic potential of circulating inflammatory biomarkers, specifically hsCRP, IL-6, TNF-α, and CD163, for predicting diabetic retinopathy (DR) in adults with recently diagnosed type 2 diabetes.METHODS: A prospective cohort of 3,363 individuals from the Danish Centre for Strategic Research in Type 2 Diabetes was followed prospectively (median follow-up of nine years). Baseline concentrations of four biomarkers were measured, and DR outcomes were assessed. Logistic regressions were used to evaluate associations with DR presence at baseline, while Cox regressions were used to analyze the development and progression of DR, adjusting for potential confounders, including HbA1c.RESULTS: No associations were observed between baseline concentrations of inflammatory biomarkers and DR presence, development, or progression over time. When comparing the highest quartile to the lowest quartile for a given biomarker in adjusted models, the hazard ratios (95% CI) for the development or progression of DR were: hsCRP 0.76 (0.55-1.03), IL-6 0.84 (0.62-1.14), TNF-α 1.03 (0.76-1.40), and CD163 0.84 (0.62-1.14).CONCLUSIONS: Our results indicate that systemic inflammatory biomarkers may not serve as reliable predictors for DR in early-stage type 2 diabetes. These findings contrast with prior cross-sectional studies suggesting a role for systemic low-grade inflammation in DR development. Inflammatory biomarkers. Diabetic retinopathy.
AB - AIMS: This study aimed to evaluate the prognostic potential of circulating inflammatory biomarkers, specifically hsCRP, IL-6, TNF-α, and CD163, for predicting diabetic retinopathy (DR) in adults with recently diagnosed type 2 diabetes.METHODS: A prospective cohort of 3,363 individuals from the Danish Centre for Strategic Research in Type 2 Diabetes was followed prospectively (median follow-up of nine years). Baseline concentrations of four biomarkers were measured, and DR outcomes were assessed. Logistic regressions were used to evaluate associations with DR presence at baseline, while Cox regressions were used to analyze the development and progression of DR, adjusting for potential confounders, including HbA1c.RESULTS: No associations were observed between baseline concentrations of inflammatory biomarkers and DR presence, development, or progression over time. When comparing the highest quartile to the lowest quartile for a given biomarker in adjusted models, the hazard ratios (95% CI) for the development or progression of DR were: hsCRP 0.76 (0.55-1.03), IL-6 0.84 (0.62-1.14), TNF-α 1.03 (0.76-1.40), and CD163 0.84 (0.62-1.14).CONCLUSIONS: Our results indicate that systemic inflammatory biomarkers may not serve as reliable predictors for DR in early-stage type 2 diabetes. These findings contrast with prior cross-sectional studies suggesting a role for systemic low-grade inflammation in DR development. Inflammatory biomarkers. Diabetic retinopathy.
KW - Diabetic retinopathy
KW - Inflammatory biomarkers
KW - Type-2-diabetes
KW - Diabetes Mellitus, Type 2/blood
KW - Prospective Studies
KW - Prognosis
KW - Interleukin-6/blood
KW - Humans
KW - Middle Aged
KW - Antigens, CD/blood
KW - Male
KW - Receptors, Cell Surface/blood
KW - Disease Progression
KW - Inflammation/blood
KW - Tumor Necrosis Factor-alpha/blood
KW - Biomarkers/blood
KW - Female
KW - Adult
KW - C-Reactive Protein/metabolism
KW - Aged
KW - Diabetic Retinopathy/blood
KW - Antigens, Differentiation, Myelomonocytic/blood
KW - CD163 Antigen
U2 - 10.1016/j.diabres.2026.113195
DO - 10.1016/j.diabres.2026.113195
M3 - Article
C2 - 41794136
SN - 0168-8227
VL - 235
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 113195
ER -