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Purpose: To evaluate the role of various vasoactive hormones in the evolution of diabetic retinopathy during pregnancy and postpartum. Methods: Retinopathy wa s graded from fundus photographs of 45 pregnant women with type 1 diabetes and s even pregnant women without diabetes in a prospective study. Markers of renin-a ngiotensin-system (RAS), plasma renin activity (PRA), angiotensin II (AngII), a ldosterone, natriuretic peptides (ANP, BNP, CNP) and adreonomedullin (AM) were m easured during the first and third trimesters and at 3 months postpartum. The wo men with diabetes were grouped by progression of retinopathy during pregnancy an d postpartum. Results: Levels of PRA (p=0.001) and ANP (p=0.03) were significant ly lower in diabetes than in non-diabetes subjects throughout pregnancy and pos tpartum. No significant differences appeared in levels of AngII, aldosterone, AM , BNP or CNP between the two groups. In multivariate logistic regression analyse s with retinopathy progression by the third trimester as the dependent variable, only duration of diabetes qualified in the model (p=0.027, R=0.227, Exp(B)=1.28 ). Conclusions: Diabetic pregnancy is associated with lower levels of PRA and AN P compared to non-diabetic pregnancy. Lowered RAS activity may contribute to th e hyperdynamic blood flow and progression of DR during diabetic pregnancy. Withi n the power of this study no clear associations between the vasoactive hormones and progression of retinopathy could be detected.
Purpose: To evaluate the role of various vasoactive hormones in the evolution of diabetic retinopathy during pregnancy and postpartum. Methods: Retinopathy wa s graded from fundus photographs of 45 pregnant women with type 1 diabetes and s even pregnant women without diabetes in a prospective study. Markers of renin-a ngiotensin-system (RAS), plasma renin activity (PRA), angiotensin II (AngII), a ldosterone, natriuretic peptides (ANP, BNP, CNP) and adreonomedullin (AM) were m easured during the first and third trimesters and at 3 months postpartum. The wo men with diabetes were grouped by progression of retinopathy during pregnancy an d postpartum. Results: Levels of PRA (p = 0.001) and ANP (p = 0.03) were significant ly lower in diabetes than in non -diabetes subjects throughout pregnancy and pos tpartum. No significant differences in levels of AngII, aldosterone, AM, BNP or CNP between the two groups. In multivariate logistic regression analysis with retinopathy progression by The third trimester as the dependent variable, only duration of diabetes qualified in the model (p = 0.027, R = 0.227, Exp (B) = 1.28). Conclusions: Diabetic pregnancy is associated with lower levels of PRA and AN P compared to non -diabetic pregnancy. Lowered RAS activity may contribute to th e hyperdynamic blood flow and progression of DR during diabetic pregnancy. Withi n the power of this study no clear associations between the vasoactive hormones and progression of retinopathy could be detected.