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Li YC, Kuan YH, Yang Y, Gau SY, Su KY, Tsai TH, Huang KH, Lee CY. Association of long-term use of dipeptidyl peptidase-4 inhibitors with the risk of diabetic retinopathy in patients with diabetes mellitus: a real-world evidence study. Front Pharmacol 2025; 16:1518545. [PMID: 40308768 PMCID: PMC12040959 DOI: 10.3389/fphar.2025.1518545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Accepted: 03/28/2025] [Indexed: 05/02/2025] Open
Abstract
Background In this study, we investigated the association of long-term use of a dipeptidyl peptidase-4 inhibitor (DPP-4i) with the risk of diabetic retinopathy (DR) in patients with diabetes mellitus (DM). Methods This study was a secondary analysis based on the nationwide database from 2008 to 2022 in Taiwan. Patients with new-onset DM who were treated with either a DPP-4i or sulfonylurea from 2009 to 2017 were included in this study. Patients who received a DPP-4i were included in the case group and further divided on the basis of the cumulative defined daily dose (cDDD) as follows: ≤90, 91-180, 181-300, and >300 cDDD. Propensity score matching was performed to select patients who used a sulfonylurea, and these patients were assigned to the control group. With adjustment for sex, age, income, urbanization level, comorbidities, and other anti-diabetic agents, the Cox proportional hazard model was used to estimate the risk of DR associated with DPP-4i use over the 5-year follow-up. Results There were 83,503 patients with DPP-4i use and 167,006 patients with sulfonylurea use after matching. Compared with patients with sulfonylurea use, patients with DPP-4i use at ≤90 cDDD had a hazard ratio (HR) of 1.43 (95% confidence interval [CI] = 1.38-1.49) for DR development, whereas those with DPP-4i use at 91-180, 181-300 or >300 cDDD had HRs of 1.66 (95% CI: 1.59-1.74), 1.82 (95% CI: 1.74-1.90), and 2.32 (95% CI: 1.91-2.82) for DR development, respectively. Of the different DPP-4is, linagliptin at ≤90 or 181-300 was associated with the highest risk of DR. Significant differences were discovered at ≤90, 91-181, and 181-300 cDDD in the risk of DR between patients using Saxagliptin versus sitagliptin. Vildagliptin at ≤90 or 91-180 cDDD was associated with an increased risk of DR, but not at 181-300 cDDD. Conclusion In patients with DM, DPP-4i at ≤90, 91-180, 181-300 and >300 cDDD was linked to an increased risk of DR over the 5-year follow-up. Sitagliptin at cDDD 181-300 was associated with the greatest DR risk. The potential for DPP-4i to accelerate DR progression should be considered.
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Affiliation(s)
- Yu-Ching Li
- Department of Public Health, China Medical University, Taichung, Taiwan
- Division of Family Medicine, Yuan Rung Hospital, Changhua, Taiwan
| | - Yu-Hsiang Kuan
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yih Yang
- Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Shuo-Yan Gau
- Department of Business Administration, National Taiwan University, Taipei, Taiwan
| | - Kun-Yu Su
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tung-Han Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Chien-Ying Lee
- Department of Pharmacology, Chung Shan Medical University, Taichung, Taiwan
- Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan
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Liu H, Zhang X, Wang Q, Li B, Bian B, Liu Y. A Comprehensive Analysis of Sex-Biased Gene Expression in the Aging Human Retina Through a Combination of Single-Cell and Bulk RNA Sequencing. Invest Ophthalmol Vis Sci 2025; 66:28. [PMID: 39804630 PMCID: PMC11734759 DOI: 10.1167/iovs.66.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 12/11/2024] [Indexed: 01/18/2025] Open
Abstract
Purpose Previous studies have reported divergent sexual responses to aging; however, specific variations in gene expression between aging males and females and their potential association with age-related retinal diseases remain unclear. This study collected data from public databases and developed a comprehensive comparison of retina between aging females and males. Methods Single-cell RNA (scRNA) and bulk RNA sequencing data of the aging retina from females and males in public databases were utilized for integrated analysis to investigate sex-biased expression in retina. Additionally, in vitro experiments were conducted on individuals with retinitis pigmentosa (RP) to validate the sex difference in degenerative retina. Results Bulk RNA analysis revealed sex-biased expression of specific genes in retina of aging individuals, with immune pathway-related genes exhibiting higher expression in females compared to males. The scRNA analysis demonstrated that sex-biased gene expression was cell-type specific in aging retina. Furthermore, susceptibility genes for age-related macular degeneration and RP exhibited variation across different cell types and sexes. Cell-to-cell communication unveiled an increased interaction associated with TGFB1, CCL7, and VEGFA in Müller glia, microglia, and astrocytes of female retina. Notably, we observed female-biased chemokine expression in microglia contributing to heightened susceptibility to immune inflammation in female retina. Finally, we confirmed a more pronounced inflammatory response during degeneration in female rd10 mouse retina compared to males. Conclusions This study provides a comprehensive comparison of retina between females and males in healthy aging human retina and highlights the significance of sex as an influential factor in retinal diseases.
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Affiliation(s)
- Hongling Liu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Xue Zhang
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Qing Wang
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Bowen Li
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
| | - Baishijiao Bian
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
- Jinfeng Laboratory, Chongqing, China
- Army 953 Hospital, Shigatse Branch of Xinqiao Hospital, Third Military Medical University (Army Medical University), Shigatse, China
- State Key Laboratory of Trauma, Burns, and Combined Injury, Department of Trauma Medical Center, Daping Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yong Liu
- Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Key Lab of Visual Damage and Regeneration & Restoration of Chongqing, Chongqing, China
- Jinfeng Laboratory, Chongqing, China
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Yaow CY, Lin SY, Xiao J, Koh JH, Yong JN, Tay PW, Tan ST. A meta-analysis of prevalence of diabetic retinopathy in Asia. Minerva Endocrinol (Torino) 2024; 49:406-418. [PMID: 35195381 DOI: 10.23736/s2724-6507.21.03585-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Diabetic retinopathy (DR) is a common microvascular complication of diabetes. This review reports the prevalence of DR in Asia and guides healthcare provision in screening and treatment. EVIDENCE ACQUISITION Medline was searched for articles describing the prevalence of DR in Asia. Statistical analysis was performed using Freeman-Tukey double arcsine transformation and the DerSimonian and Laird model. The prevalence of DR was estimated according to the following subgroups: Economic status (high, middle, and low income), country, and ethnicity. The risk of bias of the articles was also assessed. EVIDENCE SYNTHESIS A total of 66 studies were included, and out of 2,599,857 patients with diabetes, 201,646 were diagnosed with DR. The overall prevalence of DR, non-proliferative DR (NPDR), proliferative DR (PDR) and maculopathy were recorded at 21.7% (CI: 19.1-24.6%), 19.9% (CI: 17.3-22.8%), 2.3% (CI: 1.6-3.4%) and 4.8% (CI: 3.5-6.7%) respectively. Low-income countries had the lowest prevalence of DR, NPDR, PDR and maculopathy compared to the middle- and high-income countries. Middle-income countries had the highest prevalence of DR (23.9%; CI: 19.4-29.2%), NPDR (21.1%; CI: 17.0-25.9%), moderate NPDR (7.9%; CI: 5.7-11.0%), PDR (3.0%; CI: 1.8-4.9%) and maculopathy (4.7%; CI: 3.0-7.4%), while high-income countries had the highest prevalence of mild (10.3%; CI: 4.2-23.2%) and severe NPDR (3.0%; CI: 1.0-8.4%). CONCLUSIONS One in five people with diabetes have diabetic retinopathy. It is imperative that public healthcare take heeds to heighten the screening program to provide all patients with diabetes equitable access to DR screening and ophthalmology services.
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Affiliation(s)
- Clyve Y Yaow
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore -
| | - Snow Y Lin
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jieling Xiao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jin H Koh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jie N Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Phoebe W Tay
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - See T Tan
- Sengkang General Hospital, Singapore
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Bynoe K, Wang J, Sachdeva MM. Association of systemic and demographic risk factors with prevalence of retinopathy in US adults with prediabetes. Eye (Lond) 2024; 38:3093-3100. [PMID: 39003432 PMCID: PMC11544134 DOI: 10.1038/s41433-024-03227-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 06/13/2024] [Accepted: 07/05/2024] [Indexed: 07/15/2024] Open
Abstract
BACKGROUND/OBJECTIVES To investigate the relative contribution of systemic risk factors to retinopathy in prediabetes using a nationally representative cohort in the US. SUBJECTS/METHODS A group of 2098 participants aged ≥40 years with available HbA1c and gradable retinal images from the National Health and Nutrition Examination Survey 2005-2008 were included in this retrospective cross-sectional analysis. Participants were stratified into control, prediabetes, and diabetes groups based on HbA1c and anti-hyperglycaemic medication use. Logistic regression was used to assess the contribution of potential systemic risk factors to retinopathy prevalence. RESULTS The prevalence of retinopathy in the prediabetes group was 7.69%. Multivariable logistic regression revealed an inverse association of female sex (OR, 0.25; 95% CI, 0.08-0.74; p = 0.02), eGFR (OR, 0.98; 95% CI, 0.96-1.00; p = 0.04), and fasting glucose levels (OR, 0.92; 95% CI 0.87-0.98; p = 0.02) with retinopathy in individuals with prediabetes and a positive association with a Race/Ethnicity classification of "Other" (OR, 6.05; 95% CI, 1.65-22.1; p = 0.01). Comparison of ORs between groups indicated differential associations of "Other" race, fasting glucose, and C-reactive protein (CRP) with retinopathy in prediabetes compared with diabetes. CONCLUSIONS The prevalence of retinopathy among individuals with prediabetes in the NHANES database is similar to other studies. Our findings suggest that nonglycemic metabolic risk factors may be especially relevant to the risk of retinopathy in prediabetes and extend the previously suggested protective effect of female sex on retinopathy in diabetes to prediabetes. The increased odds of retinopathy in underrepresented racial/ethnic groups in the setting of prediabetes also have implications for risk assessment in this population.
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Affiliation(s)
- Kaela Bynoe
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jiangxia Wang
- Johns Hopkins Biostatistics Center, Department of Biostatistics, Johns Hopkins University, Baltimore, MD, USA
| | - Mira M Sachdeva
- Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Kenfaoui I, Bouchefra S, Daouchi S, Benzakour A, Ouhssine M. The comorbidity burden of type 2 diabetes mellitus (T2DM): sex differences and associated factors among 830 cases in North-Eastern Morocco. Diabetol Int 2024; 15:814-827. [PMID: 39469545 PMCID: PMC11513066 DOI: 10.1007/s13340-024-00750-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 07/17/2024] [Indexed: 10/30/2024]
Abstract
Background and aim Type 2 diabetes is prone to numerous comorbidities resulting from complex mechanisms involving hyperglycemia, insulin resistance, low-grade inflammation and accelerated atherogenesis. The purpose of the present study was to investigate these disorders and their associated risk factors according to patient sex in a population of type 2 diabetics in North-Eastern Morocco. Methods This study was conducted in a medical analysis laboratory over a 1-year period from 01/10/2018 to 01/10/2019. This epidemiological study was carried out on 830 subjects aged 18 and over. Quantitative variables were expressed as means ± standard deviation, and qualitative variables as frequencies and percentages. Hypothesis tests used to compare means and proportions were Student's t-test and Chi-square test of independence, respectively. Logistic regression was used to predict risk factors for each diabetes. Results 830 patients were surveyed. 95.66% had diabetes-related comorbidities. Hypertension (23.7%), nephropathy (18.19%), dyslipidemia (14.82%), thyroid dysfunction (10.72%), cataract (10.12%), diabetic foot (7.23%), ketoacidosis (6.27%), retinopathy (3.49%), and skin disorders (2.77%) were observed. Sex was associated with dyslipidemia (p = 0.025), hypertension (p = 0.032) and retinopathy (p = 0.029). Uncontrolled blood sugar, unbalanced lipid profile, age, physical activity, obesity, smoking, and alcohol consumption were risk factors with differential involvement in the occurrence of the mentioned pathologies. Conclusions The results of our study showed that a significant proportion of the population suffers from diabetic comorbidities. To meet this challenge, further research is needed to identify the mechanisms of action of these factors, to control them and combat diabetogenic environments by setting up adapted educational programs.
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Affiliation(s)
- Ikram Kenfaoui
- Laboratory of Natural Resources and Sustainable Development, Faculty of Sciences, Ibn Tofail University, Ville Haute, 14020 Kenitra, Morocco
| | - Said Bouchefra
- Laboratory of Biology and Health, Team of Nutritional Sciences, Food and Health, Faculty of Sciences, University Ibn Tofail, Hassan 2 Street N 54, Taza, 35000 FSK-Kenitra, VN Morocco
- Higher Institute of Nursing and Health Techniques, Taza, Morocco
| | - Siham Daouchi
- Laboratory of Natural Resources and Sustainable Development, Faculty of Sciences, Ibn Tofail University, Ville Haute, 14020 Kenitra, Morocco
| | - Abderrahim Benzakour
- Laboratory of Natural Resources and Sustainable Development, Faculty of Sciences, Ibn Tofail University, Ville Haute, 14020 Kenitra, Morocco
| | - Mohammed Ouhssine
- Laboratory of Natural Resources and Sustainable Development, Faculty of Sciences, Ibn Tofail University, Ville Haute, 14020 Kenitra, Morocco
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Vujosevic S, Limoli C, Piccoli G, Costanzo E, Marenzi E, Torti E, Giannini D, Polito MS, Luzi L, Nucci P, Parravano M. A gender-based analysis of retinal microvascular alterations in patients with diabetes mellitus using OCT angiography. J Diabetes Complications 2024; 38:108852. [PMID: 39213716 DOI: 10.1016/j.jdiacomp.2024.108852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 08/22/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To assess the difference in microvascular changes between males and females with diabetes mellitus (DM) without diabetic retinopathy (NoDR) and with mild-to-moderate non-proliferative diabetic retinopathy (NPDR) using Optical Coherence Tomography Angiography (OCT-A). DESIGN Retrospective cross-sectional study. METHODS 267 DM patients, 133 females (49.81 %), 111 with NoDR (41.57 %) and 156 NPDR (58.43 %) were included. Foveal-centered 3 × 3 mm OCT-A images corresponding to the superficial (SCP), intermediate (ICP) and deep capillary plexus (DCP), and full retinal (RET) slab were used for analysis. For each slab, FAZ area, perimeter, and circularity index (CI) were determined, following manual delineation of the FAZ; perfusion (PD) and vessel density (VD), fractal dimension (FD), vessel length density (VLD), geometric perfusion deficits (GPD) were also computed. Flow voids (FV) were determined in the choriocapillaris plexus; and perfused capillary density (PCD) in the RET slab. RESULTS Females showed larger FAZ CI in SCP and greater FAZ area and perimeter than males in NPDR group. Males had higher central macular thickness than females in NPDR group. All density metrics at the level of ICP and DCP were affected in the NPDR group with no gender differences. Of note, the same significant findings were found in type 1 DM patients, and not in type 2 DM patients. CONCLUSIONS Our OCT-A findings suggest significant microvascular changes in females with NPDR compared to males, but no such differences in patients without DR. Therefore, gender-related vascular alterations might be present in early stages of DR with potential role.
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Affiliation(s)
- Stela Vujosevic
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy; Eye Clinic, IRCCS MultiMedica, Milan, Italy.
| | | | | | | | - Elisa Marenzi
- Laboratory of Custom Computing and Programmable Systems, Department of Electrical, Computer and Biomedical Engineering, Università degli Studi di Pavia, Pavia, Lombardia, Italy
| | - Emanuele Torti
- Laboratory of Custom Computing and Programmable Systems, Department of Electrical, Computer and Biomedical Engineering, Università degli Studi di Pavia, Pavia, Lombardia, Italy
| | | | | | - Livio Luzi
- Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Paolo Nucci
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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Huang Z, Chen LJ, Huang D, Yi J, Chen Z, Lin P, Wang Y, Zheng J, Chen W. Preoperative Intravitreal Conbercept Injection Reduced Both Angiogenic and Inflammatory Cytokines in Patients With Proliferative Diabetic Retinopathy. J Diabetes Res 2024; 2024:2550367. [PMID: 39308630 PMCID: PMC11416173 DOI: 10.1155/2024/2550367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/21/2024] [Accepted: 08/17/2024] [Indexed: 09/25/2024] Open
Abstract
Aims: To investigate the impact of intravitreal injection of conbercept, a recombinant fusion protein with decoy receptors for the vascular endothelial growth factor (VEGF) family, on intraocular concentrations of angiogenic and inflammatory mediators in patients with proliferative diabetic retinopathy (PDR), analyzed its potential impact on surgical outcomes. Methods: Forty eyes from 40 patients with PDR were included in this prospective study. Patients received intravitreal injection of conbercept followed by vitrectomy or phacovitrectomy in 1 week. Aqueous humor samples were collected before and 1 week after the conbercept injection. The concentrations of angiogenic and inflammatory cytokines and chemokines were measured by flow cytometry. Follow-up clinical data were collected and analyzed. Results: Intravitreal conbercept injection significantly decreased aqueous concentrations of VEGF (325.5 (baseline) versus 22.3 pg/mL (postinjection), p < 0.0001), PlGF (39.5 versus 24.5 pg/mL, p < 0.0001), and PDGF-A (54.1 versus 47.0 pg/mL, p = 0.0016), while no impact on bFGF levels. For inflammatory mediators, the concentration of TNF-α (0.79 versus 0.45 pg/mL, p = 0.0004) and IL-8 (180.6 versus 86 pg/mL, p < 0.0001) were decreased, while IL-6 (184.1 versus 333.7 pg/mL, p = 0.0003) and IL-10 (1.1 versus 1.5 pg/mL, p = 0.0032) were increased. No significant changes in IFN-γ or MCP-1 were detected. Three months after surgery, the mean best-corrected visual acuity improved from a baseline of 1.8 ± 0.1 logMAR to 0.7 ± 0.1 logMAR (p < 0.0001), with 36 eyes (90%) achieving an improvement of visual function. Conclusions: Intravitreal conbercept injection presents dual effects of antiangiogenesis and anti-inflammation and can be served as an adjuvant treatment to vitrectomy for PDR patients.
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Affiliation(s)
- Zijing Huang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Li Jia Chen
- Department of Ophthalmology & Visual SciencesThe Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Dingguo Huang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Jingsheng Yi
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Zhiying Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
- Fifth Clinical InstituteShantou University Medical College, Shantou, Guangdong, China
| | - Peimin Lin
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Yifan Wang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Jianlong Zheng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Weiqi Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
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Fang Y, Wang Q, Li Y, Zeng L, Liu J, Ou K. On implications of somatostatin in diabetic retinopathy. Neural Regen Res 2024; 19:1984-1990. [PMID: 38227526 DOI: 10.4103/1673-5374.390955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 10/10/2023] [Indexed: 01/17/2024] Open
Abstract
Somatostatin, a naturally produced neuroprotective peptide, depresses excitatory neurotransmission and exerts anti-proliferative and anti-inflammatory effects on the retina. In this review, we summarize the progress of somatostatin treatment of diabetic retinopathy through analysis of relevant studies published from February 2019 to February 2023 extracted from the PubMed and Google Scholar databases. Insufficient neuroprotection, which occurs as a consequence of declined expression or dysregulation of retinal somatostatin in the very early stages of diabetic retinopathy, triggers retinal neurovascular unit impairment and microvascular damage. Somatostatin replacement is a promising treatment for retinal neurodegeneration in diabetic retinopathy. Numerous pre-clinical and clinical trials of somatostatin analog treatment for early diabetic retinopathy have been initiated. In one such trial (EUROCONDOR), topical administration of somatostatin was found to exert neuroprotective effects in patients with pre-existing retinal neurodysfunction, but had no impact on the onset of diabetic retinopathy. Overall, we concluded that somatostatin restoration may be especially beneficial for the growing population of patients with early-stage retinopathy. In order to achieve early prevention of diabetic retinopathy initiation, and thereby salvage visual function before the appearance of moderate non-proliferative diabetic retinopathy, several issues need to be addressed. These include the needs to: a) update and standardize the retinal screening scheme to incorporate the detection of early neurodegeneration, b) identify patient subgroups who would benefit from somatostatin analog supplementation, c) elucidate the interactions of somatostatin, particularly exogenously-delivered somatostatin analogs, with other retinal peptides in the context of hyperglycemia, and d) design safe, feasible, low cost, and effective administration routes.
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Affiliation(s)
- Yanhong Fang
- Department of Ophthalmology, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Qionghua Wang
- Department of Ophthalmology, Chongqing University Jiangjin Hospital, Chongqing, China
| | - Youjian Li
- College of Pharmacy, National & Local Joint Engineering Research Center of Targeted and Innovative Therapeutics, IATTI, Chongqing University of Arts and Sciences, Chongqing, China
| | - Li Zeng
- Shandong Provincial Hospital, Shandong Laboratory Animal Center, Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province, China
| | - Jian Liu
- Academic Unit of Ophthalmology, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kepeng Ou
- College of Pharmacy, National & Local Joint Engineering Research Center of Targeted and Innovative Therapeutics, IATTI, Chongqing University of Arts and Sciences, Chongqing, China
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Pei X, Huang D, Li Z. Genetic insights and emerging therapeutics in diabetic retinopathy: from molecular pathways to personalized medicine. Front Genet 2024; 15:1416924. [PMID: 39246572 PMCID: PMC11378321 DOI: 10.3389/fgene.2024.1416924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 08/12/2024] [Indexed: 09/10/2024] Open
Abstract
Diabetic retinopathy (DR) is a major complication of diabetes worldwide, significantly causing vision loss and blindness in working-age adults, and imposing a substantial socioeconomic burden globally. This review examines the crucial role of genetic factors in the development of DR and highlights the shift toward personalized treatment approaches. Advances in genetic research have identified specific genes and variations involved in angiogenesis, inflammation, and oxidative stress that increase DR susceptibility. Understanding these genetic markers enables early identification of at-risk individuals and the creation of personalized treatment plans. Incorporating these genetic insights, healthcare providers can develop early intervention strategies and tailored treatment plans to improve patient outcomes and minimize side effects. This review emphasizes the transformative potential of integrating genetic information into clinical practice, marking a paradigm shift in DR management and advancing toward a more personalized and effective healthcare model.
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Affiliation(s)
- Xiaoting Pei
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Duliurui Huang
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhijie Li
- Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Henan University, People's Hospital of Zhengzhou University, Zhengzhou, China
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Chen C, Meng S, Wu X, Ciren W, Shen J, Zeding Z, Yang L, Tian Q, Lv X, Le Y. Vitamin D deficiency and the risk of diabetic retinopathy in patients with type 2 diabetes in Tibet: a cross-sectional analysis. BMC Endocr Disord 2024; 24:139. [PMID: 39095726 PMCID: PMC11295715 DOI: 10.1186/s12902-024-01668-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 07/24/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is one of the most common complications of diabetes worldwide. The aim of this study was to assess the prevalence of DR in hospitalized patients with type 2 diabetes (T2DM) in Tibet and to identify risk factors that may influence the occurrence of DR. METHODS This was a cross-sectional study conducted in a third-class hospital in the Tibet Autonomous Region. The prevalence of DR in hospitalized patients with T2DM was measured. Univariate and multivariate logistic regression, restricted cubic spline (RCS) analysis and receiver-operating characteristic curve analysis were used to investigate the risk factors for DR. RESULTS The prevalence of DR was 29.3%. The duration of diabetes; concentrations of 25-OH-VitD3, hemoglobin, fasting insulin, alanine aminotransferase, total bilirubin, and creatinine; and HOMA-IR were significantly different between DR patients and non-DR patients (all P < 0.05). Univariate and multivariate logistic regression revealed that a longer duration of diabetes and lower 25-OH-VitD3 levels were associated with increased DR risk. RCS analysis suggested overall positive associations of the duration of diabetes and 25-OH-VitD3 concentrations with DR risk (P nonlinearity < 0.05). The turning points for the duration of diabetes and 25-OH-VitD3 concentrations were 5.1 years and 10.6 ng/mL, respectively. The sensitivity, specificity, and area under the receiver-operating characteristic curve for the combination of the duration of diabetes and 25-OH-VitD3 levels were 79.4%, 69.4% and 0.764, respectively. CONCLUSIONS Given the high prevalence of DR in hospitalized patients with T2DM in Tibet, vitamin D supplementation seems to be important in the prevention of DR to some degree.
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Affiliation(s)
| | - Shuyou Meng
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, 850000, China
| | - Xiaolong Wu
- School of Medicine, Tibet University, Lhasa, China
| | - Wangmu Ciren
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, 850000, China
| | - Jing Shen
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, 850000, China
| | - Zhuoma Zeding
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, 850000, China
| | - Lihui Yang
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, 850000, China
- Institute of Tibet Plateau Medical Research, People's Hospital of Tibet Autonomous Region, Lhasa, China
| | - Qing Tian
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, 100191, China
| | - Xuemei Lv
- Department of Endocrinology and Metabolism, People's Hospital of Tibet Autonomous Region, Lhasa, 850000, China.
| | - Yunyi Le
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, 100191, China.
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11
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Zhang T, Ying H, Wang H, Zhao F, Pan Q, Zhan Q, Zhang F, An Q, Liu T, Hu Y, Zhang Y. Visual motion sensitivity as an indicator of diabetic retinopathy in type 2 diabetes mellitus. Front Neurosci 2024; 18:1412241. [PMID: 39156633 PMCID: PMC11327050 DOI: 10.3389/fnins.2024.1412241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/24/2024] [Indexed: 08/20/2024] Open
Abstract
Objectives This current study is based on a set of visual motion sensitivity tests, investigating the correlation between visual motion sensitivity and diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM), thereby furnishing a scientific rationale for preventing and controlling DR. Methods This research was conducted by a combination of questionnaire collection and on-site investigation that involved 542 T2DM recruited from a community. The visual motion sensitivity determined the visual motion perception of the participants across three spatial frequencies (low, medium, and high) for both the first- and second-order contrast. The logistic regression model was adopted to investigate the relationship between visual motion sensitivity and DR prevalence. Besides, the Pearson correlation analysis was used to analyze the factors influencing visual motion sensitivity and restricted cubic spline (RCS) functions to assess the dose-response relationship between visual motion sensitivity and glycated hemoglobin. Results Among 542 subjects, there are 162 cases of DR, with a prevalence rate of 29.89%. After adjusting factors of age, gender, glycated hemoglobin, duration of diabetes, BMI, and hypertension, we found that the decline in first- and second-order high spatial frequency sensitivity increased the risk for DR [odds ratio (OR): 1.519 (1.065, 2.168), 1.249 (1.068, 1.460)]. The decline in perceptual ability of second-order low, medium, and high spatial frequency sensitivity is a risk factor for moderate to severe DR [OR: 1.556 (1.116, 2.168), 1.388 (1.066, 1.806), 1.476 (1.139, 1.912)]. The first-order and the second-order high spatial frequency sensitivity are significantly positively correlated with glycated hemoglobin (r = 0.105, p = 0.015 and r = 0.119, p = 0.005, respectively). Conclusion Visual motion sensitivity especially for the second-order high spatial frequency stimuli emerges as a significant predictor of DR in T2DM, offering a sensitive diagnostic tool for early detection.
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Affiliation(s)
- Tianlin Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Haojiang Ying
- Department of Psychology, Soochow University, Suzhou, China
| | - Huiqun Wang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Fouxi Zhao
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Qiying Pan
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Qingqing Zhan
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Fuyan Zhang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Qinyu An
- Medical College, Guizhou University, Guiyang, China
| | - Tao Liu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Yuandong Hu
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Yang Zhang
- Department of Psychology, Soochow University, Suzhou, China
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12
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Ji Q, Chai S, Zhang R, Li J, Zheng Y, Rajpathak S. Prevalence and co-prevalence of comorbidities among Chinese adult patients with type 2 diabetes mellitus: a cross-sectional, multicenter, retrospective, observational study based on 3B study database. Front Endocrinol (Lausanne) 2024; 15:1362433. [PMID: 38919489 PMCID: PMC11196810 DOI: 10.3389/fendo.2024.1362433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Purpose This study aimed to investigate the prevalence and co-prevalence of comorbidities among Chinese individuals with type 2 diabetes (T2DM). Methods Medical records were retrospectively retrieved from the 3B Study database, which provided a comprehensive assessment of comorbid conditions in Chinese adult outpatients with T2DM. Patient characteristics, laboratory measures, and comorbidities were summarized via descriptive analyses, overall and by subgroups of age (<65, 65-74, 75 years) and gender. Results Among 25,454 eligible patients, 53% were female, and the median age was 63 years. The median time of diabetes duration was 6.18 years. A total of 20,309 (79.8%) patients had at least one comorbid condition alongside T2DM. The prevalence of patients with one, two, three, and four or more comorbid conditions was 28.0%, 24.6%, 15.6%, and 11.6%, respectively. Comorbidity burden increased with longer T2DM duration. Older age groups also exhibited higher comorbidity burden. Females with T2DM had a higher overall percentage of comorbidities compared to males (42.7% vs. 37.1%). The most common comorbid conditions in T2DM patients were hypertension (HTN) in 59.9%, overweight/obesity in 58.3%, hyperlipidemia in 42.0%, retinopathy in 16.5%, neuropathy in 15.2%, cardiovascular disease (CVD) in 14.9%, and renal disease in 14.4%. The highest co-prevalence was observed for overweight/obesity and HTN (37.6%), followed by HTN and hyperlipidemia (29.8%), overweight/obesity and hyperlipidemia (27.3%), HTN and CVD (12.6%), HTN and retinopathy (12.1%), and HTN and renal disease (11.3%). Conclusion The majority of T2DM patients exhibit multiple comorbidities. Considering the presence of multimorbidity is crucial in clinical decision-making. Systematic review registration https://clinicaltrials.gov/, identifier NCT01128205.
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Affiliation(s)
- Qiuhe Ji
- Department of Endocrinology and Metabolism, Xi’an International Medical Center Hospital, Shanxi, China
| | - Shangyu Chai
- Value & Implementation Global Medical & Scientific Affairs, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | - Ruya Zhang
- Value & Implementation Global Medical & Scientific Affairs, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | - Jihu Li
- Government Affairs & Market Access, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | - Yiman Zheng
- Value & Implementation Global Medical & Scientific Affairs, Merck Sharp & Dohme (MSD) China, Shanghai, China
| | - Swapnil Rajpathak
- Value & Implementation Outcomes Research, Merck Research Laboratories, Merck & Co., Inc., Rahway, NJ, United States
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13
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Du K, Luo W. Association between blood urea nitrogen levels and diabetic retinopathy in diabetic adults in the United States (NHANES 2005-2018). Front Endocrinol (Lausanne) 2024; 15:1403456. [PMID: 38800479 PMCID: PMC11116622 DOI: 10.3389/fendo.2024.1403456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Objective To investigate the association between blood urea nitrogen (BUN) levels and diabetic retinopathy (DR) in adults with diabetes mellitus (DM). Methods Seven cycles of cross-sectional population information acquired from NHANES(national health and nutrition examination surveys) 2005-2018 were collected, from which a sample of diabetic adults was screened and separated into two groups based on whether or not they had DR, followed by weighted multivariate regression analysis. This study collected a complete set of demographic, biological, and sociological risk factor indicators for DR. Demographic risk factors comprised age, gender, and ethnicity, while biological risk factors included blood count, blood pressure, BMI, waist circumference, and glycated hemoglobin. Sociological risk factors included education level, deprivation index, smoking status, and alcohol consumption. Results The multiple regression model revealed a significant connection between BUN levels and DR [odds ratio =1.04, 95% confidence interval (1.03-1.05), p-value <0.0001],accounting for numerous variables. After equating BUN levels into four groups, multiple regression modeling showed the highest quartile (BUN>20 mg/dl) was 2.22 times more likely to develop DR than the lowest quartile [odds ratio =2.22, 95% confidence interval (1.69-2.93), p- value <0.0001]. Subgroup analyses revealed that gender, race, diabetes subtype, and duration of diabetes had a regulating effect on the relationship between BUN and DR. Conclusion BUN levels were related with an increased prevalence of DR, particularly in individuals with BUN >20 mg/dl. These findings highlight the significance of BUN level in assessing the risk of DR.
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Affiliation(s)
| | - Wenjuan Luo
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, China
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14
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Mokhtarpour K, Yadegar A, Mohammadi F, Aghayan S, Seyedi S, Rabizadeh S, Esteghamati A, Nakhjavani M. Impact of Gender on Chronic Complications in Participants With Type 2 Diabetes: Evidence From a Cross-Sectional Study. Endocrinol Diabetes Metab 2024; 7:e488. [PMID: 38718275 PMCID: PMC11078530 DOI: 10.1002/edm2.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/13/2024] [Accepted: 04/20/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION This study aimed to assess and compare the prevalence of diabetes complications between men and women with Type 2 diabetes (T2D), as well as how gender relates to these complications. METHODS In this cross-sectional study, complications of diabetes, including coronary artery disease (CAD), retinopathy, neuropathy and diabetic kidney disease (DKD), were evaluated in 1867 participants with T2D. Additionally, baseline characteristics of the individuals, including anthropometric measurements, metabolic parameters and the use of dyslipidaemia drugs and antihyperglycaemic agents, were assessed. Gender differences in complications were examined using the chi-squared test. Multivariate logistic regression was employed to investigate the relationship between gender and T2D complications, with and without adjusting for the characteristics of the studied population. RESULTS In the studied population, 62.1% had at least one complication, and complications were 33.5% for DKD, 29.6% for CAD, 22.9% for neuropathy and 19.1% for retinopathy. The prevalence of CAD and neuropathy was higher in men. However, DKD and retinopathy were more prevalent among women. Odds ratios of experiencing any complication, CAD and retinopathy in men compared with women were 1.57 (95% CI: 1.27-2.03), 2.27 (95% CI: 1.72-2.99) and 0.72 (95% CI: 0.52-0.98), respectively, after adjusting for demographic factors, anthropometric measures, metabolic parameters and the consumption of dyslipidaemia drugs and antihyperglycaemic agents. CONCLUSION The prevalence of diabetes complications was significantly higher in men with diabetes, highlighting the need for better treatment adherence. CAD was associated with the male gender, whereas retinopathy was associated with the female gender. Men and women with diabetes should be monitored closely for CAD and retinopathy, respectively, regardless of their age, diabetes duration, anthropometric measures, laboratory findings and medications.
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Affiliation(s)
- Kiavash Mokhtarpour
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Fatemeh Mohammadi
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Seyedeh Nazanin Aghayan
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Seyed Arsalan Seyedi
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Vali‐Asr HospitalTehran University of Medical SciencesTehranIran
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15
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Yu J, Brelen ME, Chan CKM, Chen ZJ, Mohamed S, Yam JC, Lam DSC, Pang CP, Tham CC, Chen LJ. Genetic association of TIE2 with diabetic retinopathy and diabetic macular edema. Asia Pac J Ophthalmol (Phila) 2024; 13:100068. [PMID: 38750959 DOI: 10.1016/j.apjo.2024.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 09/18/2024] Open
Abstract
PURPOSE To evaluate the associations of the TIE2 gene with diabetic retinopathy (DR) and diabetic macular edema (DME). METHODS This study included a Chinese cohort of 285 non-proliferative DR patients and 433 healthy controls. The DR patients were classified further into those with or without DME. Thirty haplotype-tagging single-nucleotide polymorphisms (SNPs) in TIE2 were genotyped using TaqMan technology. Associations of DR and subtypes were analyzed by logistic regression adjusted for age and sex. Stratification association analysis by sex was performed. RESULTS TIE2 rs625767 showed a nominal but consistent association with DR [odds ratio (OR) = 0.71, P = 0.005] and subtypes (DR without DME: OR = 0.69, P = 0.016; DME: OR = 0.73, P = 0.045). SNP rs652010 was consistently associated with overall DR (OR = 0.74, P = 0.011) and DR without DME (OR = 0.70, P = 0.016), but not with DME. Moreover, SNPs rs669441, rs10967760, rs549099 and rs639225 showed associations with overall DR, whilst rs17761403, rs664461 and rs1413825 with DR without DME. In stratification analysis, three SNPs, rs625767 (OR = 0.62, P = 0.005), rs669441 (OR = 0.63, P = 0.006) and rs652010 (OR = 0.64, P = 0.007), were associated with DR in females, but not in males. Moreover, one haplotype T-T defined by rs625767 and rs669441 was significantly associated with DR in females only. CONCLUSIONS This study revealed TIE2 as a susceptibility gene for DR and DME in Chinese, with a sex-specific association in females. Further validation should be warranted.
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Affiliation(s)
- Jun Yu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Marten E Brelen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Eye Hospital, Hong Kong; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong
| | - Carmen K M Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Eye Hospital, Hong Kong
| | - Zhen Ji Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Shaheeda Mohamed
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Eye Hospital, Hong Kong
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Eye Hospital, Hong Kong
| | - Dennis S C Lam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; C-MER Dennis Lam & Partners Eye Center, C-MER International Eye Care Group, Hong Kong
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Eye Hospital, Hong Kong
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Hong Kong Eye Hospital, Hong Kong; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong.
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16
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Zhao LZ, Li WM, Ma Y. Prevalence and risk factors of diabetes mellitus among elderly patients in the Lugu community. World J Diabetes 2024; 15:638-644. [PMID: 38680701 PMCID: PMC11045422 DOI: 10.4239/wjd.v15.i4.638] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/29/2024] [Accepted: 02/27/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Age is a significant risk factor of diabetes mellitus (DM). With the develop of population aging, the incidence of DM remains increasing. Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM. AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals. METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed. The prevalence of DM among the elderly was calculated. The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure (DBP) and systolic blood pressure (SBP), fasting blood glucose, body mass index (BMI), waist-to-hip ratio (WHR) and incidence of hypertension (HT), coronary heart disease (CHD), and chronic kidney disease (CKD). RESULTS DM was diagnosed in 32.70% of the 4816 elderly people. The BMI of the DM group (25.16 ± 3.35) was greater than that of the non-DM group (24.61 ± 3.78). The WHR was 0.90 ± 0.04 in the non-DM group and 0.90 ± 0.03 in the DM group, with no significant difference. The left SBP and SBP in the DM group were 137.9 mmHg ± 11.92 mmHg and 69.95 mmHg ± 7.75 mmHg, respectively, while they were 126.6 mmHg ± 12.44 mmHg and 71.15 mmHg ± 12.55 mmHg, respectively, in the non-DM group. These findings indicate higher SBP and lower DBP in DM patients than in those without DM. In the DM group, 1274 patients were diagnosed with HT, accounting for 80.89%. Among the 3241 non-DM patients, 1743 (53.78%) were hypertensive and 1498 (46.22%) were nonhypertensive. The DM group had more cases of HT than did the non-DM group. There were more patients with CHD or CKD in the DM group than in the non-DM group. There were more patients who drank alcohol more frequently (≥ 3 times) in the DM group than in the non-DM group. CONCLUSION Older adults in the Lugu community are at a greater risk of DM. In elderly individuals, DM is closely related to high BMI and HT, CHD, and CKD. Physical examinations should be actively carried out for elderly people to determine their BMI, SBP, DBP, and other signs, and sufficient attention should be given to abnormalities in the above signs before further diagnosis.
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Affiliation(s)
- Li-Zhen Zhao
- Lugu Community Health Service Center, West Campus Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing 100043, China
| | - Wei-Min Li
- Lugu Community Health Service Center, West Campus Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing 100043, China
| | - Ying Ma
- Lugu Community Health Service Center, West Campus Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing 100043, China
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17
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Cen Y, Feng D, Kowsar R, Cheng Z, Luo Y, Xiao Q. Sex-Specific Variations in the mRNA Levels of Candidate Genes in Peripheral Blood Mononuclear Cells from Patients with Diabetes: A Multistep Study. Endocr Res 2024; 49:59-74. [PMID: 37947760 DOI: 10.1080/07435800.2023.2280571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Type 2 diabetes (T2D) is one of the most prevalent diseases that also show sexual dimorphism in many different aspects. OBJECTIVES This study aimed to distinguish the mRNA expression of genes in peripheral blood mononuclear cells (PBMCs) in men or women with T2D using a multistep analysis. METHODS A total of 95 patients with T2D were compared based on their sex in terms of clinical variables and mRNA expression in their PBMCs. RESULTS Men with T2D had lower LDLC, HDLC, and HbA1c values in their blood, but greater creatinine levels. In men with T2D, TLR4, CCR2, NOX2, and p67phox mRNA expression was greater, but IL6 and NF-κB mRNA expression was lesser in PBMCs. There was a link between fasting plasma glucose (FPG), triglycerides, and hs-CRP, as well as COX1 mRNA in men with T2D. In women with T2D, FPG was associated with the mRNA expression of THBS1 and p67phox, as well as triglycerides and HDLC levels. We found the exclusive effect of FPG on HDLC, HbA1c, as well as p67phox mRNA in PBMCs of women with T2D. Analysis revealed the exclusive effect of FPG on hs-CRP and PAFR mRNA in PBMCs of men with T2D. FPG was shown to be associated with body mass index, hs-CRP, triglycerides, and COX1 mRNA in men with T2D, and with serum triglycerides, THSB1, and p67phox mRNA in women with T2D, according to network analysis. HbA1c was linked with NF-κB mRNA in women with T2D. CONCLUSIONS Using a multistep analysis, it was shown that network analysis outperformed traditional analytic techniques in identifying sex-specific alterations in mRNA gene expression in PBMCs of T2D patients. The development of sex-specific therapeutic approaches may result from an understanding of these disparities.
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Affiliation(s)
- Yuzhen Cen
- Department of Blood Transfusion, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Dana Feng
- Department of Blood Transfusion, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Rasoul Kowsar
- Department of Animal Science, College of Agriculture, Isfahan University of Technology, Isfahan, Iran
| | - Zhen Cheng
- Guantian Community Healthcare Center, Shenzhen Baoan Shiyan People's Hospital, Shenzhen, China
| | - Yu Luo
- Guantian Community Healthcare Center, Shenzhen Baoan Shiyan People's Hospital, Shenzhen, China
| | - Qingyu Xiao
- Department of Blood Transfusion, Shenzhen Baoan Shiyan People's Hospital, Shenzhen, China
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18
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Hou X, Wang L, Zhu D, Guo L, Weng J, Zhang M, Zhou Z, Zou D, Ji Q, Guo X, Wu Q, Chen S, Yu R, Chen H, Huang Z, Zhang X, Wu J, Wu J, Jia W. Prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy in adults with diabetes in China. Nat Commun 2023; 14:4296. [PMID: 37463878 DOI: 10.1038/s41467-023-39864-w] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 06/28/2023] [Indexed: 07/20/2023] Open
Abstract
The current epidemic status of diabetic retinopathy in China is unclear. A national prevalence survey of diabetic complications was conducted. 50,564 participants with gradable non-mydriatic fundus photographs were enrolled. The prevalence rates (95% confidence intervals) of diabetic retinopathy and vision-threatening diabetic retinopathy were 16.3% (15.3%-17.2%) and 3.2% (2.9%-3.5%), significantly higher in the northern than in the southern regions. The differences in prevalence between those who had not attained a given metabolic goal and those who had were more pronounced for Hemoglobin A1c than for blood pressure and low-density lipoprotein cholesterol. The participants with vision-threatening diabetic retinopathy had significantly higher proportions of visual impairment and blindness than those with non-vision-threatening diabetic retinopathy. The likelihoods of diabetic retinopathy and vision-threatening diabetic retinopathy were also associated with education levels, household income, and multiple dietary intakes. Here, we show multi-level factors associated with the presence and the severity of diabetic retinopathy.
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Affiliation(s)
- Xuhong Hou
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, Beijing, China
| | - Jianping Weng
- Department of Endocrinology, the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiguang Zhou
- Institute of Metabolism and Endocrinology, Key Laboratory of Diabetes Immunology, Ministry of Education, National Clinical Research Center for Metabolic Diseases, the Second Xiangya Hospital and the Diabetes Center, Central South University, Changsha, Hunan Province, China
| | - Dajin Zou
- Department of Endocrinology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Qiuhe Ji
- Department of Endocrinology, Xijing Hospital, Xi'an, Shaanxi Province, China
| | - Xiaohui Guo
- Department of Endocrinology, Peking University First Hospital, Beijing, China
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Siyu Chen
- Department of Endocrinology and Metabolism, Suzhou Dushu Lake Hospital (Dushu Lake Hospital Affiliated to Soochow University), Suzhou, Jiangsu Province, China
| | - Rong Yu
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Hongli Chen
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiarui Wu
- Key Laboratory of Systems Health Science of Zhejiang Province, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, Zhejiang Province, China
- Center for Excellence in Molecular Science, Chinese Academy of Sciences, Shanghai, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
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El-Tawab SS, Ibrahim IK, Megallaa MH, Mgeed RMA, Elemary WS. Neutrophil–lymphocyte ratio as a reliable marker to predict pre-clinical retinopathy among type 2 diabetic patients. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2023. [DOI: 10.1186/s43166-023-00177-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Abstract
Background
Diabetic retinopathy is now recognized as a neurovascular in lieu of a microvascular complication. Visual evoked potentials (VEPs) are greatly valuable in detecting early diabetic retinal functional changes before the occurrence of structural damage. Low-grade inflammation plays a fundamental part in the development and progression of retinopathy in diabetics. Detecting diabetic patients with early retinopathy before the occurrence of clinical symptoms provides a window of opportunity to ensure the best prognosis for these eyes. Neutrophil–lymphocyte ratio (NLR) has recently been introduced as a novel marker of inflammation in various diseases. Indeed, the presence of a cheap, available, and reliable marker of inflammation that is capable to detect pre-clinical diabetic retinopathy (P-DR) is crucial for early intervention to retard the progression of ocular damage. As far as we know no previous studies investigated the role of NLR in the detection of P-DR. The aim of this study was to investigate the quality of prediction of NLR in detecting pre-clinical retinopathy in type 2 diabetic patients.
Results
In this case–control study, VEPs results showed a significant delay in P100 latencies of the patients’ group compared to the control group. According to the VEPs results, the patient group was further subdivided into two: diabetic with VEPs changes (a group with P-DR) and diabetic without VEPs changes. NLR was significantly elevated in patients with P-DR (p < 0.001). NLR cut-off point ≥ 1.97 is able to predict P-DR with 89.29% sensitivity and 84.37% specificity. Linear regression model revealed that NLR is the only independent factor that predicts P-DR. (odds ratio 3.312; 95% confidence interval 1.262–8.696, p = 0.015*.
Conclusions
Visual evoked potentials have an important role to evaluate the visual pathway in diabetics and to diagnose pre-clinical diabetic retinopathy before the occurrence of structural damage. Neutrophil–lymphocyte ratio is a reliable marker for the detection of pre-clinical diabetic retinopathy with good sensitivity (89.29%) and specificity (84.37%). Finding a reliable available laboratory test to predict P-DR could be of help to save diabetic patients from serious ocular complications.
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Meng C, Xing Y, Huo L, Ma H. Relationship Between Estimated Glucose Disposal Rate and Type 2 Diabetic Retinopathy. Diabetes Metab Syndr Obes 2023; 16:807-818. [PMID: 36959899 PMCID: PMC10028301 DOI: 10.2147/dmso.s395818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE To investigate the association between diabetic retinopathy (DR), DR intensity, and estimated glucose disposal rate (eGDR) in individuals with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS This study comprised 1762 T2DM patients who were admitted between January and December, 2021. Overall, the DR was identified in 430 patients. Based on the eGDR, the participants were divided into four study groups. One-way analysis of variance was used to compare the groups. The correlations between eGDR and DR risk, eGDR, and DR severity were analyzed using regression analysis. Furthermore, these relationships were analyzed in different sex groups. RESULTS Patients with T2DM had a 19.75% (348/1762) DR detection rate, whereas those with DR had a 22.41% (78/348) proliferative DR detection rate. The DR group had substantially reduced levels of eGDR compared with the non-DR group. Multivariate logistic regression analysis demonstrated that reduced eGDR was an independent risk factor for DR, after adjusting for confounding variables. eGDR correlated significantly with proliferative DR in women but not in men. CONCLUSION In Chinese individuals with T2DM, lower eGDR was independently associated with a higher risk of DR.
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Affiliation(s)
- Cuiqiao Meng
- Health Examination Center, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Yuling Xing
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Graduate School of Hebei Medical University, Shijiazhuang, People’s Republic of China
| | - Lijing Huo
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang, People’s Republic of China
| | - Huijuan Ma
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, People’s Republic of China
- Hebei Key Laboratory of Metabolic Diseases, Hebei General Hospital, Shijiazhuang, Hebei, People’s Republic of China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People’s Republic of China
- Correspondence: Huijuan Ma, Department of Endocrinology, Hebei General Hospital, Shijiazhuang, 050051, People’s Republic of China, Tel +86 18032838686, Email
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21
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Ding C, Wang N, Wang Z, Yue W, Li B, Zeng J, Yoshida S, Yang Y, Zhou Y. Integrated Analysis of Metabolomics and Lipidomics in Plasma of T2DM Patients with Diabetic Retinopathy. Pharmaceutics 2022; 14:pharmaceutics14122751. [PMID: 36559245 PMCID: PMC9786316 DOI: 10.3390/pharmaceutics14122751] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Diabetic retinopathy (DR) is a major cause of blindness worldwide and may be non-proliferative (NPDR) or proliferative (PDR). To Investig.gate the metabolomic and lipidomic characteristics of plasma in DR patients, plasma samples were collected from patients with type 2 diabetes mellitus (DR group) with PDR (n = 27), NPDR (n = 18), or no retinopathy (controls, n = 21). Levels of 54 and 41 metabolites were significantly altered in the plasma of DR patients under positive and negative ion modes, respectively. By subgroup analysis, 74 and 29 significantly changed plasma metabolites were detected in PDR patients compared with NPDR patients under positive and negative ion modes, respectively. KEGG analysis indicated that pathways such as biosynthesis of amino acids and neuroactive ligand-receptor interaction were among the most enriched pathways in altered metabolites in the DR group and PDR subgroup. Moreover, a total of 26 and 41 lipids were significantly changed in the DR group and the PDR subgroup, respectively. The panel using the 29-item index could discriminate effectively between diabetic patients with and without retinopathy, and the panel of 22 items showed effective discrimination between PDR and NPDR. These results provide a basis for further research into the therapeutic targets associated with these metabolite and lipid alterations.
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Affiliation(s)
- Chun Ding
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Nan Wang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Zicong Wang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Wenyun Yue
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Bingyan Li
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Jun Zeng
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, Kurume 830-0011, Japan
| | - Yan Yang
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Correspondence: (Y.Y.); (Y.Z.)
| | - Yedi Zhou
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Hunan Clinical Research Center of Ophthalmic Disease, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Correspondence: (Y.Y.); (Y.Z.)
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22
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Naserrudin NA, Jeffree MS, Kaur N, Rahim SSSA, Ibrahim MY. Study on the Development of a Conceptual Framework to Identify the Risk Factors of Diabetic Retinopathy among Diabetic Patients: A Concept Paper. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12426. [PMID: 36231721 PMCID: PMC9564907 DOI: 10.3390/ijerph191912426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/12/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
The most common complication of diabetes mellitus (DM) is diabetic retinopathy (DR). The control of DR risk factors is essential for the effective prevention of DR. There is currently a lack of research to guide DR-related research in Malaysia. This concept paper aimed to review published studies and propose a conceptual framework (CF) as a guide for future research to determine the prevalence of DR and its risk factors across DM patients. After a review of prior research, this study has presented a CF that takes into account these four key elements: the patient's sociodemographic characteristics, comorbidities, complications, and diabetes conditions, namely, the length of the disease and glycaemic control. In the suggested CF, ethnicity was highlighted as a crucial risk factor for DR across lower- to middle-income countries (LMIC) and multiracial countries. In order to guide future studies, scientific guidance is essential. The proposed CF would help future research to conduct scientific research related to DR. Also, the proposed CF was tailored to suit research across LMIC and multiracial countries.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
- Sabah State Health Department, Malaysia Ministry of Health, Tingkat 3, Rumah Persekutuan, Jalan Mat Salleh, Peti Surat 11290, Kota Kinabalu 88590, Sabah, Malaysia
| | - Mohammad Saffree Jeffree
- Department of Public Health Medicine, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia
| | - Nirmal Kaur
- Sabah State Health Department, Malaysia Ministry of Health, Tingkat 3, Rumah Persekutuan, Jalan Mat Salleh, Peti Surat 11290, Kota Kinabalu 88590, Sabah, Malaysia
| | - Syed Sharizman Syed Abdul Rahim
- Department of Public Health Medicine, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia
| | - Mohd Yusof Ibrahim
- Department of Public Health Medicine, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia
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Abdelrahman AA, Bunch KL, Sandow PV, Cheng PNM, Caldwell RB, Caldwell RW. Systemic Administration of Pegylated Arginase-1 Attenuates the Progression of Diabetic Retinopathy. Cells 2022; 11:cells11182890. [PMID: 36139465 PMCID: PMC9497170 DOI: 10.3390/cells11182890] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/12/2022] [Accepted: 09/14/2022] [Indexed: 12/02/2022] Open
Abstract
Diabetic retinopathy (DR) is a serious complication of diabetes that results from sustained hyperglycemia, hyperlipidemia, and oxidative stress. Under these conditions, inducible nitric oxide synthase (iNOS) expression is upregulated in the macrophages (MΦ) and microglia, resulting in increased production of reactive oxygen species (ROS) and inflammatory cytokines, which contribute to disease progression. Arginase 1 (Arg1) is a ureohydrolase that competes with iNOS for their common substrate, L-arginine. We hypothesized that the administration of a stable form of Arg1 would deplete L-arginine’s availability for iNOS, thus decreasing inflammation and oxidative stress in the retina. Using an obese Type 2 diabetic (T2DM) db/db mouse, this study characterized DR in this model and determined if systemic treatment with pegylated Arg1 (PEG-Arg1) altered the progression of DR. PEG-Arg1 treatment of db/db mice thrice weekly for two weeks improved visual function compared with untreated db/db controls. Retinal expression of inflammatory factors (iNOS, IL-1β, TNF-α, IL-6) was significantly increased in the untreated db/db mice compared with the lean littermate controls. The increased retinal inflammatory and oxidative stress markers in db/db mice were suppressed with PEG-Arg1 treatment. Additionally, PEG-Arg1 treatment restored the blood–retinal barrier (BRB) function, as evidenced by the decreased tissue albumin extravasation and an improved endothelial ZO-1 tight junction integrity compared with untreated db/db mice.
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Affiliation(s)
- Ammar A. Abdelrahman
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Katharine L. Bunch
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Porsche V. Sandow
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Paul N-M Cheng
- Bio-Cancer Treatment International, Bioinformatics Building, Hong Kong Science Park, Tai Po, Hong Kong SAR 511513, China
| | - Ruth B. Caldwell
- Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Department of Cell Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - R. William Caldwell
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Culver Vision Discovery Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
- Correspondence: ; Tel.: +1-706-721-2345
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Yao X, Pei X, Fan S, Yang X, Yang Y, Li Z. Relationship between renal and liver function with diabetic retinopathy in patients with type 2 diabetes mellitus: a study based on cross-sectional data. Sci Rep 2022; 12:9363. [PMID: 35672376 PMCID: PMC9174192 DOI: 10.1038/s41598-022-13164-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 05/05/2022] [Indexed: 11/12/2022] Open
Abstract
This study aims to explore the relationship between abnormal renal- and liver-function and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). A total of 994 T2DM patients who received inpatient treatment in the Endocrinology Department of Henan Province People’s Hospital were included in the study. Logistic regression was performed to identify the relationship between abnormal renal and liver function with DR. Receiver operator characteristic analysis was performed to explore the efficacy of risk factors in predicting DR. Higher urine albumin [OR(95%CI) = 3.344(1.921–5.822), P < 0.001] and urine albumin/creatinine ratio [OR (95%CI) = 2.901(1.911–5.822), P < 0.001] were closely related to the occurrence of DR. People with low TP had a 1.624-times higher risk (95%CI: 1.008–2.617) of developing DR than those with normal total protein (P = 0.046). The more risk factors that are present, the greater the risk of DR. For every one-point incremental increase in the risk-factor score, the risk of DR increased by 31.0% (P < 0.001). The area under receiver operating curve of risk-factor score was 0.839 (0.812, 0.866), with a sensitivity of 81.9% and a specificity of 74.8%. The risk of developing DR increased with an increased risk-factor score. These findings are potentially valuable for DR screening and early diagnosis in patients with T2DM.
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Affiliation(s)
- Xi Yao
- Henan Eye Institute, Henan Eye Hospital, and Henan Key Laboratory of Ophthalmology and Visual Science, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Xiaoting Pei
- Henan Eye Institute, Henan Eye Hospital, and Henan Key Laboratory of Ophthalmology and Visual Science, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan, China.
| | - Shuoning Fan
- Henan Eye Institute, Henan Eye Hospital, and Henan Key Laboratory of Ophthalmology and Visual Science, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Xueke Yang
- School of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China
| | - Yingrui Yang
- Henan Eye Institute, Henan Eye Hospital, and Henan Key Laboratory of Ophthalmology and Visual Science, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Zhijie Li
- Henan Eye Institute, Henan Eye Hospital, and Henan Key Laboratory of Ophthalmology and Visual Science, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, Henan, China.
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25
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Xu Y, Wang A, Lin X, Xu J, Shan Y, Pan X, Ye J, Shan P. Global burden and gender disparity of vision loss associated with diabetes retinopathy. Acta Ophthalmol 2021; 99:431-440. [PMID: 33124190 DOI: 10.1111/aos.14644] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 08/04/2020] [Accepted: 09/17/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE To assess the trend patterns and gender disparity in global burden of vision loss due to diabetic retinopathy (DR) by year, age, region and socioeconomic status using prevalence and years lived with disability (YLDs) from Global Burden of Disease (GBD) study 2017. METHODS Prevalence and YLDs data of vision loss attributable to DR were extracted from GBD Study 2017 in 195 countries and territories. Socio-demographic Index (SDI) in 2017 was cited as indicators of socioeconomic status. Kruskal-Wallis test, Dunn's multiple comparisons and Pearson linear correlation were adopted to evaluate the gender disparity and association with socioeconomic levels. RESULTS Globally, total age-standardized prevalence and YLDs rates of vision loss due to DR peaked around 2005, with prevalence rate of 58.98 [95% uncertainty interval (UI) 50.95-68.56] and YLDs rate of 5.00 (95% UI 3.51-6.84) per 100 000 population, respectively. The burden were expected to increase to 65.74 (95% UI 60.14-70.86) and 5.68 (95% UI 4.07-7.22) by 2050. The burden would increase according to our projection based on current epidemiological situation. However, gender disparity has existed since 1990 and been enlarging in recent years, with female being more heavily impacted. This pattern remained with ageing among different stages of vision impairments and varied through GBD super regions. Gender difference (females minus males) of age-standardized prevalence rates was positively related to SDI (r = 0.1661, p = 0.0203). Diabetes has become a more important risk over the past 3 decades among the leading causes of vision loss. CONCLUSIONS The DR-related vision loss burden tended to increase under ageing population according to our projection with significant gender disparity. Public awareness of DR and gender sensitive health policy should be emphasized.
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Affiliation(s)
- Yufeng Xu
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Aihong Wang
- Department of Endocrinology PLA Strategic Support Force Characteristic Medical Center Beijing China
| | - Xiling Lin
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Jingya Xu
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Yi Shan
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Xiaowen Pan
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Juan Ye
- Department of Ophthalmology College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
| | - Peng‐Fei Shan
- Department of Endocrinology and Metabolism College of Medicine the Second Affiliated Hospital of Zhejiang University Hangzhou China
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