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Lisha LB, Helen Sulochana C. DEC-DRR: deep ensemble of classification model for diabetic retinopathy recognition. Med Biol Eng Comput 2024; 62:2911-2938. [PMID: 38713340 DOI: 10.1007/s11517-024-03076-1] [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: 02/04/2023] [Accepted: 03/16/2024] [Indexed: 05/08/2024]
Abstract
Most diabetes patients are liable to have diabetic retinopathy (DR); however, the majority of them might not be even aware of the ailment. Therefore, early detection and treatment of DR are necessary to prevent vision loss. But, avoiding DR is not a simple process. An ophthalmologist can typically identify DR through an optical evaluation of the fundus and through the evaluation of color pictures. However, due to the increased count of DR patients, this could not be possible as it consumes more time. To rectify this problem, a novel deep ensemble-based DR classification technique is developed in this work. Initially, a Wiener filter (WF) is applied for preprocessing the image. Then, the enhanced U-Net-based segmentation process is done. Subsequent to the segmentation process, features are extracted that include statistical features, inferior superior nasal temporal (ISNT), cup to disc ratio (CDR), and improved LGBP as well. Further, deep ensemble classifiers (DEC) like CNN, Bi-GRU, and DMN are used to recognize the disease. The outcomes from DMN, CNN, and Bi-GRU are then subjected to improved SLF. Additionally, the weights of DMN, CNN, and Bi-GRU are adjusted via pelican updated Tasmanian devil optimization (PU-TDO). Finally, outputs on DR (microaneurysms, hemorrhages, hard exudates, and soft exudates) are obtained. The performance of DEC + PU-TDO for diabetic retinopathy is computed over extant models with regard to different measures for four datasets. The results on accuracy using the DEC + PU-TDO scheme for the IDRID dataset is maximum around 0.975 at 90th LP while other models have less accuracy. The FPR of DEC + PU-TDO is less around 0.039 at the 90th LP for the SUSTech-SYSU dataset, while other extant models have maximum FPR.
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Affiliation(s)
- L B Lisha
- Department of Computer Science and Engineering, Marthandam College of Engineering and Technology, Kuttakuzhi, Veeyannoor, Kanyakumari, Tamil Nadu, India.
| | - C Helen Sulochana
- Department of Electronics and Communication Engineering, St. Xavier's Catholic College of Engineering, Chunkankadai, Kanyakumari, Tamil Nadu, India
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Lima PHB, Goncalves CV, Ribeiro IS, Galantini MPL, Muniz IPR, Santos GS, Silva RAADA. Diabetes and hypertension in elderly women: interactions between severity and failure to control inflammation. AN ACAD BRAS CIENC 2024; 96:e20230844. [PMID: 38922257 DOI: 10.1590/0001-3765202420230844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 04/04/2024] [Indexed: 06/27/2024] Open
Abstract
Elderly women are more susceptible to the development of chronic non-communicable diseases. Among these, diabetes mellitus (DM) and systemic arterial hypertension (SAH) stand out. This work aimed to carry out an expanded study on the interactions of anthropometric, biochemical and inflammatory parameters associated with the risk of severity in elderly women with hypertension and diabetes. The study involved the evaluation of 126 elderly women with hypertension and diabetes mellitus. The women were divided according disease severity (low, moderate, high and very high). Anthropometric data were collected by bioimpedance analysis. The inflammatory and biochemical data were obtained from volunteer blood samples. Waist circumference, waist circumference/height ratio, and systolic and diastolic pressures increased with severity. Biochemical marker levels increased with risk of severity, except HDLc. In the very high risk group, there was a higher IL-1β, IFN-γ and TNF-α production, however, lower IL-10 levels were observed. The very high risk group showed change values for the IL-10/IL-1β, IL-10/IL-17 and IL-10/TNF-α ratios. The results showed to be extensively altered in the very high risk group, where the inflammatory profile loses its responsiveness. This is the first study that shows an expanded view of the different parameters evaluated in elderly women with hypertension and diabetes.
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Affiliation(s)
- Paulo Henrique B Lima
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Caroline V Goncalves
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Israel S Ribeiro
- Universidade Federal do Sul da Bahia, Centro de Formação em Ciências da Saúde, Praça Joana Angélica, 58, São José, 45988-058 Teixeira de Freitas, BA, Brazil
| | - Maria Poliana L Galantini
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Igor P R Muniz
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
- Universidade Estadual do Sudoeste da Bahia/UESB, Departamento de Ciências da Saúde, Campus Vitória da Conquista, Estr. Bem Querer, Km 04, 45031-300 Vitória da Conquista, BA, Brazil
| | - Gilvanéia S Santos
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
| | - Robson A A DA Silva
- Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua Rio de Contas, 58, Bloco 17, Lote 58, Candeias, 45029-094 Vitória da Conquista, BA, Brazil
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Zhang Y, Liu H. Correlation between insulin resistance and the rate of neutrophils-lymphocytes, monocytes-lymphocytes, platelets-lymphocytes in type 2 diabetic patients. BMC Endocr Disord 2024; 24:42. [PMID: 38528483 PMCID: PMC10962197 DOI: 10.1186/s12902-024-01564-x] [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: 07/04/2023] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Insulin resistance (IR) was a prominent feature commonly observed in individuals with type 2 diabetes mellitus (T2DM). T2DM Individuals often exhibited a concomitant presence of low-grade chronic inflammation. In this study conducted retrospectively, the aim was to investigate the connection between neutrophils-lymphocytes rate (NLR), monocytes-lymphocytes rate (MLR), platelets-lymphocytes rate (PLR) and IR, specifically among individuals with T2DM. METHOD This study encompassed a cohort of 405 individuals diagnosed with T2DM, comprising cases from January 2021 to November 2022. On the basis of whether there was IR or not, these sufferers were categorized into two cohorts, namely T2DM with IR group (292 cases) and T2DM without IR group (113 cases), as determined by a homeostasis model assessment-IR (HOMA-IR) value exceeding 2.0. RESULTS The findings of this study demonstrated compelling evidence of distinct biomarker profiles between individuals with T2DM who had IR and those without IR. Specifically, the IR individuals displayed notably raise NLR, MLR, PLR, C reactive protein (CRP) and serum amyloid A (SAA). Additionally, there was a noticeable decrease in superoxide dismutase (SOD) levels. Furthermore, IR was negatively correlated with SOD values, while positive associations were found between IR and NLR, CRP, and SAA levels (p < 0.05). Moreover, a rise in NLR and PLR levels demonstrated an identical relationship with the prevalence of IR (p = 0.007, p = 0.025, separately). The Receiver operating characteristic (ROC) curve demonstrated that the areas under the curve (AUC) for NLR, MLR, PLR, CRP, SAA and SOD in predicting occurrence of IR in T2DM patients were 0.603, 0.575, 0.581, 0.644, 0.594 and 0.632 respectively, with sensitivity of 79.5%, 95.2%, 46.9%,54.1% (or 51.4), 47.6% (or 45.7%) and 98.6% and specificity of 37.2%, 19.5%, 69.9%, 69% (or 71.7%), 71.6% (or 73.5%) and 23% respectively. CONCLUSION Our findings support the notion that higher magnitude of NLR, PLR, MLR, CRP, and SAA values, corresponded to lower SOD levels, indicating a more severe degree of IR in T2DM patients. Additionally, NLR, PLR, MLR, CRP, SAA, and SOD demonstrated predictive potential for assessing IR. Regrettably, due to the retrospective nature of this study, it was not feasible to take a measurement the majority of inflammatory factors and reactive oxygen species (ROS).
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Affiliation(s)
- Yuanyuan Zhang
- Endocrinology Department, Senile Disease Center, The First Affiliated Hospital of Anhui, University of Traditional Chinese Medicine, 117 Meishan Road, 230009, Hefei, Anhui, China
| | - Huaizhen Liu
- Endocrinology Department, Senile Disease Center, The First Affiliated Hospital of Anhui, University of Traditional Chinese Medicine, 117 Meishan Road, 230009, Hefei, Anhui, China.
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Liu R, Zhang J, Gu W, Zhao X, Xiao L, Yang C. Dietary Inflammatory Index and diabetic retinopathy risk in US adults: findings from NHANES (2005-2008). BMC Ophthalmol 2024; 24:46. [PMID: 38291352 PMCID: PMC10826025 DOI: 10.1186/s12886-024-03303-1] [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: 03/18/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Inflammation is associated with the pathophysiology of diabetic retinopathy (DR). Within the framework of complete dietary patterns, the Dietary Inflammatory Index (DII) was formulated to evaluate the inflammatory properties inherent in a diet. The main purpose of the current study was to assess the relationship between DII and DR using National Health and Nutrition Examination Survey (NHANES). METHODS The original sample size included 1,148 diabetes patients out of 2005-2008 NHANES surveys. Twenty-four-hour dietary consumptions were used to calculate the DII scores. Demographic characteristics and retina examinations were collected for the comparison between DR and non-DR groups in diabetes patients. The relationship between DII and DR was analyzed by a logistic regression model. RESULTS 227 subjects (110 non-DR and 117 DR) were selected in the analyses by using undersampling method to balance the sample size. Compared with non-DR group, DR group had higher DII values (1.14 ± 0.29 vs. 1.49 ± 0.21, p = 0.32), higher levels of HbA1c (6.8 ± 1.1% vs. 7.7 ± 2.6%, p < 0.001), longer duration of diabetes (6.52 ± 12 years vs. 14 ± 11 years, p < 0.001). The odds rate (OR) of DII for DR from the logistic regression was 1.38 (95%CI 1.06-1.81, p < 0.001). HbA1c, diabetes duration and obesity were important influencing factors, and their ORs were 1.81 (95% CI:1.31-2.50), 1.12 (95%CI:1.04-1.20), 4.01 (95%CI:1.12-14.32), respectively. In addition, the most important dietary indices for DR were different across males and females. CONCLUSIONS The current study demonstrates that a higher DII is associated with an increased risk of DR in US adults. Considering diet as a modifiable factor, limiting pro-inflammatory diets or encouraging an anti-inflammatory diet may be a promising and cost-effective method in the management of DR.
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Affiliation(s)
- Rong Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, 221004, Xuzhou, China
| | - Jiechang Zhang
- Department of Cardiology, Zhuhai People's Hospital, Zhuhai, China
| | - Wen Gu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, 221004, Xuzhou, China
| | - Xiujuan Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Sun Yat-sen University, Guangzhou, China
| | - Lishun Xiao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, 221004, Xuzhou, China.
| | - Chengcheng Yang
- Department of Ophthalmology, The Fifth Affiliated Hospital of Sun Yat-sen University, 52 Meihua Road, 519000, Zhuhai, China.
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Błaszkiewicz M, Walulik A, Florek K, Górecki I, Sławatyniec O, Gomułka K. Advances and Perspectives in Relation to the Molecular Basis of Diabetic Retinopathy-A Review. Biomedicines 2023; 11:2951. [PMID: 38001952 PMCID: PMC10669459 DOI: 10.3390/biomedicines11112951] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
Diabetes mellitus (DM) is a growing problem nowadays, and diabetic retinopathy (DR) is its predominant complication. Currently, DR diagnosis primarily relies on fundoscopic examination; however, novel biomarkers may facilitate that process and make it widely available. In this current review, we delve into the intricate roles of various factors and mechanisms in DR development, progression, prediction, and their association with therapeutic approaches linked to the underlying pathogenic pathways. Specifically, we focus on advanced glycation end products, vascular endothelial growth factor (VEGF), asymmetric dimethylarginine, endothelin-1, and the epigenetic regulation mediated by microRNAs (miRNAs) in the context of DR.
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Affiliation(s)
- Michał Błaszkiewicz
- Student Scientific Group of Adult Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland
| | - Agata Walulik
- Student Scientific Group of Adult Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland
| | - Kamila Florek
- Student Scientific Group of Adult Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland
| | - Ignacy Górecki
- Student Scientific Group of Adult Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland
| | - Olga Sławatyniec
- Student Scientific Group of Adult Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland
| | - Krzysztof Gomułka
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland
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Zhang H, Chen N. Adropin as an indicator of T2DM and its complications. FOOD SCIENCE AND HUMAN WELLNESS 2022. [DOI: 10.1016/j.fshw.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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White NH, Pan Q, Knowler WC, Schroeder EB, Dabelea D, Chew EY, Blodi B, Goldberg RB, Pi-Sunyer X, Darwin C, Schlögl M, Nathan DM. Risk Factors for the Development of Retinopathy in Prediabetes and Type 2 Diabetes: The Diabetes Prevention Program Experience. Diabetes Care 2022; 45:2653-2661. [PMID: 36098658 PMCID: PMC9679265 DOI: 10.2337/dc22-0860] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/14/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine glycemic and nonglycemic risk factors that contribute to the presence of diabetic retinopathy (DR) before and after the onset of type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS During the Diabetes Prevention Program (DPP) and DPP Outcome Study (DPPOS), we performed fundus photography over time in adults at high risk for developing T2D, including after they developed diabetes. Fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study (ETDRS) grading system, with DR defined as typical lesions of DR (microaneurysms, exudates, hemorrhage, or worse) in either eye. RESULTS By DPPOS year 16 (∼20 years after random assignment into DPP), 24% of 1,614 participants who had developed T2D and 14% of 885 who remained without diabetes had DR. In univariate analyses, using results from across the entire duration of follow-up, American Indian race was associated with less frequent DR compared with non-Hispanic White (NHW) race, and higher HbA1c, fasting and 2-h plasma glucose levels during an oral glucose tolerance test, weight, and history of hypertension, dyslipidemia, and smoking, but not treatment group assignment, were associated with more frequent DR. On multivariate analysis, American Indian race was associated with less DR compared with NHW (odds ratio [OR] 0.36, 95% CI 0.20-0.66), and average HbA1c was associated with more DR (OR 1.92, 95% CI 1.46-1.74 per SD [0.7%] increase in HbA1c). CONCLUSIONS DR may occur in adults with prediabetes and early in the course of T2D. HbA1c was an important risk factor for the development of DR across the entire glycemic range from prediabetes to T2D.
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Affiliation(s)
- Neil H. White
- Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO
| | - Qing Pan
- The Biostatistics Center, Milken Institute School of Public Health, George Washington University, Rockville, MD
| | - William C. Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ
| | | | - Dana Dabelea
- Colorado School of Public Health, Anschutz Medical Campus, Aurora, CO
| | - Emily Y. Chew
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD
| | - Barbara Blodi
- Wisconsin Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Ronald B. Goldberg
- Diabetes Research Institute, University of Miami Miller School of Medicine, Miami, FL
| | | | - Christine Darwin
- Department of Medicine/Endocrinology Diabetes, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Mathias Schlögl
- University Clinic for Acute Geriatric Care, City Hospital Waid Zurich, Zurich, Switzerland
| | - David M. Nathan
- Diabetes Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Kuo CYJ, Murphy R, Rupenthal ID, Mugisho OO. Correlation between the progression of diabetic retinopathy and inflammasome biomarkers in vitreous and serum – a systematic review. BMC Ophthalmol 2022; 22:238. [PMID: 35624430 PMCID: PMC9145105 DOI: 10.1186/s12886-022-02439-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/05/2022] [Indexed: 11/15/2022] Open
Abstract
Activation of the NOD-like receptor protein 3 (NLRP3) inflammasome pathway has been implicated in Diabetic retinopathy (DR) pathogenesis, but its impact on DR development and progression remains unclear. Therefore, the primary aim of this systematic literature review was to determine the role of the inflammasome in DR development. Furthermore, the secondary aim was to determine whether systemic inflammasome activity can be used to predict DR progression. Studies measuring vitreous and/or serum inflammasome biomarkers in DR patients with Type 2 Diabetes Mellitus (T2DM) were searched systematically using online databases EMBASE, PubMed and Web of Science with the last search conducted on 29th of September 2021. The risk of bias was assessed using the Newcastle Ottawa Scale and 20 studies were eligible for narrative analysis. Limitations included the heterogeneity in detection assays used, the small and uneven sample size, a lack of vitreous data in earlier disease stages, and not accounting for patients with other systemic co-morbidities. Analysis showed that inflammasome biomarkers IL-1β and IL-18 increased significantly from non-proliferative DR to proliferative DR in both vitreous and serum, suggesting the inflammasome pathway is activated as DR progresses and that serum inflammasome levels could be explored as potential biomarkers for DR progression.
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Vieira M, Fernandes R, Ambrósio AF, Cardoso V, Carvalho M, Weng Kung P, Neves MAD, Mendes Pinto I. Lab-on-a-chip technologies for minimally invasive molecular sensing of diabetic retinopathy. LAB ON A CHIP 2022; 22:1876-1889. [PMID: 35485913 DOI: 10.1039/d1lc01138c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Diabetic retinopathy (DR) is the most common diabetic eye disease and the worldwide leading cause of vision loss in working-age adults. It progresses from mild to severe non-proliferative or proliferative DR based on several pathological features including the magnitude of blood-retinal barrier breakdown and neovascularization. Available pharmacological and retinal laser photocoagulation interventions are mostly applied in the advanced stages of DR and are inefficient in halting disease progression in a significantly high percentage of patients. Yet, recent evidence has shown that some therapies could potentially limit DR progression if applied at early stages, highlighting the importance of early disease diagnostics. In the past few decades, different imaging modalities have proved their utility for examining retinal and optic nerve changes in patients with retinal diseases. However, imaging based-methodologies solely rely on morphological examination of the retinal vascularization and are not suitable for recurrent and personalized patient evaluation. This raises the need for new technologies to enable accurate and early diagnosis of DR. In this review, we critically discuss the potential clinical benefit of minimally-invasive molecular biomarker identification and profiling of diabetic patients who are at risk of developing DR. We provide a comparative overview of conventional and recently developed lab-on-a-chip technologies for quantitative assessment of potential DR molecular biomarkers and discuss their advantages, current limitations and challenges for future practical implementation and continuous patient monitoring at the point-of-care.
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Affiliation(s)
- Maria Vieira
- International Iberian Nanotechnology Laboratory (INL), Braga, Portugal
| | - Rosa Fernandes
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - António F Ambrósio
- Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
- Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
| | - Vanessa Cardoso
- CMEMS-UMinho, University of Minho, Campus of Azurém, Guimarães, Portugal
- LABBELS - Associate Laboratory, Guimarães, Braga, Portugal
| | - Mariana Carvalho
- International Iberian Nanotechnology Laboratory (INL), Braga, Portugal
| | - Peng Weng Kung
- Spin Dynamics in Health Engineering Group, Songshan Lake Materials Laboratory, Dongguan, China
| | | | - Inês Mendes Pinto
- International Iberian Nanotechnology Laboratory (INL), Braga, Portugal
- Institute for Research and Innovation in Health (i3S), Porto, Portugal.
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Gao X, Wang X, Zhong Y, Liu L, Teng W, Shan Z. Serum Antithyroglobulin Antibody Levels Are Associated with Diabetic Retinopathy among Euthyroid Type 2 Diabetes Patients: A Hospital-Based, Retrospective Study. J Diabetes Res 2022; 2022:2552186. [PMID: 35036446 PMCID: PMC8758256 DOI: 10.1155/2022/2552186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Previous studies have revealed that the variation of thyroid indicators may be associated with the risk of diabetic retinopathy (DR) among euthyroid type 2 diabetes (T2D) patients. But the specific conclusions are currently inconsistent. METHODS This is a hospital-based retrospective survey. We recruited 1,145 euthyroid T2D patients and checked the thyroid function and fundus photographs. The modified Airlie House classification system was used to categorize the stages of DR. The association between thyroid indicators and different stages of DR was analyzed. RESULTS We divided free triiodothyronine (FT3) into tertiles and found that the prevalence of mild nonproliferative DR (NPDR) was significantly higher in T2, compared with T1 (32.0% vs. 25.2%, p < 0.05). When FT3 was within the level of T2, FT3 could be an independent risk factor for mild NPDR (OR 1.426, 95% CI (1.031, 1.971), p < 0.05). In addition, the prevalence of severe NPDR and proliferative DR (PDR) was significantly higher in thyroglobulin antibody (TgAb) positive group (8.8% vs. 4.1%, p < 0.05) and vice versa (33.3% vs. 18.4%, p < 0.05). TgAb positivity was also an independent risk factor for severe NPDR and PDR (OR 2.212, 95% CI (1.244, 3.934), p < 0.05). CONCLUSIONS We hardly observed a significant change in DR risk with the elevation or reduction of serum TSH or thyroid hormone within the reference interval. Although the slightly elevated FT3 may be associated to mild NPDR, the extensibility of this result remains to be seen. For T2D patients with euthyroid function, there may be a significant correlation between serum TgAb positivity and severe NPDR and PDR.
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Affiliation(s)
- Xiaotong Gao
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
| | - Xichang Wang
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
| | - Yifan Zhong
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110001, China
| | - Lei Liu
- Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110001, China
| | - Weiping Teng
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism and the Institute of Endocrinology, The NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang 110001, China
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Erdem B, Kaya Y. Prediction of diabetic retinopathy in patients with type 2 diabetes mellitus by using monocyte to high-density lipoprotein-cholesterol ratio. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Yang N, Lu YF, Yang X, Jiang K, Sang AM, Wu HQ. Association between cystatin C and diabetic retinopathy among type 2 diabetic patients in China: a Meta-analysis. Int J Ophthalmol 2021; 14:1430-1440. [PMID: 34540622 DOI: 10.18240/ijo.2021.09.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/14/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the correlation between cystatin C (Cys-C) and diabetic retinopathy (DR) in those patients with type 2 diabetes mellitus (DM) in China. METHODS Articles were collected from China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, EMBASE, Cochrane Library, Clinical Trials.gov, and Google Scholar. Quality and risk of bias within included studies was assessed using the Newcastle-Ottawa scale (NOS). Heterogeneity was determined by using Cochran's Q-test and Higgins I 2 statistics. Mean differences (MDs) and 95% confidence intervals (CIs) of Cys-C within the diabetes without retinopathy (DWR) and DR, DWR and non-proliferative diabetic retinopathy (NPDR), NPDR and proliferative diabetic retinopathy (PDR) were collected by using random-effects model because of high heterogeneity. Meta-analysis was conducted based on 23 articles of 2331 DR including NPDR and PDR patients and 2023 DWR patients through Review Manager 5.3. Subgroup analyses were also performed according to DM duration, body mass index (BMI), total cholesterol (TC), total triglycerides (TG), low-density lipoprotein C (LDL-C), and high-density lipoprotein C (HDL-C), sample origins and methods. Publication bias was assessed by the funnel plot. RESULTS Cys-C level in DR patients was increased compared with that of DWR (total MD: 0.69, 95%CI: 0.41 to 0.97, Z=4.79, P<0.01). Besides, the synthesized results of the studies showed the similar findings in the DWR vs NPDR group (total MD: 0.29, 95%CI 0.20 to 0.39, Z=6.02, P<0.01) and the NPDR vs PDR group (total MD: 0.63, 95%CI 0.43 to 0.82, Z=6.33, P<0.01). Heterogeneity of most of the subgroup analyses was still obvious (I 2≥50%, P<0.1). Forest plots of different subgroups indicated that there was a slight increase of Cys-C during the period between DWR and DR, DWR and NPDR, NPDR and PDR. Funnel plot showed that there was no significant publication bias. CONCLUSION The elevated Cys-C is closely related with DR and probably plays a critical role in its progression.
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Affiliation(s)
- Nan Yang
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Yun-Fei Lu
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Xiao Yang
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Kui Jiang
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Ai-Min Sang
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Hui-Qun Wu
- Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China
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Trotta MC, Gesualdo C, Platania CBM, De Robertis D, Giordano M, Simonelli F, D'Amico M, Drago F, Bucolo C, Rossi S. Circulating miRNAs in diabetic retinopathy patients: Prognostic markers or pharmacological targets? Biochem Pharmacol 2021; 186:114473. [PMID: 33607073 DOI: 10.1016/j.bcp.2021.114473] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022]
Abstract
In this study we analyzed the expression of circulating miRNAs, in the serum of diabetic retinopathy (DR) patients. Five miRNAs (hsa-miR-195-5p, hsa-miR-20a-5p, hsa-miR-20b-5p, hsa-miR-27b-3p and hsa-miR-451a) were validated as biomarkers for stratification of DR stages, from the early non-proliferative (NPDR) to the late proliferative (PDR) phase. Furthermore, circulating levels of these miRNAs correlated with retinal hyper-reflective spots (HRS), assessed by optical coherence tomography (OCT). The number of HRS increased with worsening of DR stages. On the contrary, no significant vascular density differences between NPDR and PDR patients were detected by angio-OCT (OCTA). A post-hoc bioinformatics analysis associated these five miRNAs to target genes belonging to the "Tumor Necrosis Factor alfa signaling" pathway, and several molecules were predicted to modify miRNAs expression. In conclusion, correlation between specific circulating miRNAs and intraretinal hyper-reflective spots was demonstrated, confirming that these miRNAs were validated as prognostic biomarkers, and also as potential pharmacological targets, warranting further clinical evaluation to explore novel therapeutics for diabetic retinopathy.
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Affiliation(s)
- Maria Consiglia Trotta
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Carlo Gesualdo
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Chiara Bianca Maria Platania
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Domenico De Robertis
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mauro Giordano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesca Simonelli
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Michele D'Amico
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy; Center for Research in Ocular Pharmacology, CERFO, University of Catania, Catania, Italy
| | - Claudio Bucolo
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy; Center for Research in Ocular Pharmacology, CERFO, University of Catania, Catania, Italy.
| | - Settimio Rossi
- Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Han W, Wei H, Kong W, Wang J, Yang L, Wu H. Association between retinol binding protein 4 and diabetic retinopathy among type 2 diabetic patients: a meta-analysis. Acta Diabetol 2020; 57:1203-1218. [PMID: 32405713 DOI: 10.1007/s00592-020-01535-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/07/2020] [Indexed: 12/23/2022]
Abstract
AIMS The aim of this study was to investigate the association between retinol-binding protein 4 (RBP4) and diabetic retinopathy (DR) among patients with type 2 diabetes mellitus (T2DM). METHODS Databases PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure, VIP, and Wangfang were searched to July 30, 2019. The Newcastle-Ottawa Scale was applied to assess the quality of all identified studies, and those qualified were included in the meta-analysis. The Chi squared Q test and I2 statistics were conducted to evaluate heterogeneity. Standardized mean differences (SMD) and 95% confidence intervals (CI) among RBP4 within the DR and T2DM without retinopathy (DWR) groups were pooled using the random effects model depending on the heterogeneity. Subgroup analyses were conducted among the groups having different diabetes duration, detection methods, body mass index, and total cholesterol and triglyceride levels. The funnel plot was used to assess publication bias. RESULTS Nineteen observational studies were included in our meta-analysis. RBP4 was significantly higher in both nonproliferative DR (SMD: 0.72, 95% CI 0.48-0.95, P < 0.00001) and proliferative DR (SMD: 2.68, 95% CI 1.69-3.67, P < 0.00001) groups despite high heterogeneity (I2 = 87 and 97% in DR and PDR groups, respectively). Significant differences were noted among most subgroups (P < 0.05). Among those accompanied by hypercholesterolemia, the association between RBP4 and DR were unclear (P = 0.09). CONCLUSIONS Elevated RBP4 is strongly associated with DR and may play an essential role in its progression. Additional large-scale controlled studies are needed to confirm these findings.
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Affiliation(s)
- Wentao Han
- Department of Medical Informatics, Medical School of Nantong University, Nantong, 226001, People's Republic of China
| | - Huagen Wei
- Department of Medical Informatics, Medical School of Nantong University, Nantong, 226001, People's Republic of China
| | - Weizheng Kong
- Department of Medical Informatics, Medical School of Nantong University, Nantong, 226001, People's Republic of China
| | - Jing Wang
- Department of Medical Informatics, Medical School of Nantong University, Nantong, 226001, People's Republic of China
| | - Luqian Yang
- Department of Medical Informatics, Medical School of Nantong University, Nantong, 226001, People's Republic of China
| | - Huiqun Wu
- Department of Medical Informatics, Medical School of Nantong University, Nantong, 226001, People's Republic of China.
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Optical Coherence Tomography Parameters Related to Vision Impairment in Patients with Diabetic Macular Edema: A Quantitative Correlation Analysis. J Ophthalmol 2020; 2020:5639284. [PMID: 33062313 PMCID: PMC7537709 DOI: 10.1155/2020/5639284] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/10/2020] [Accepted: 07/31/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose To quantitatively explore the correlation between optical coherence tomography (OCT) parameters and vision impairment in patients with diabetic macular edema (DME). Methods This study was a retrospective observational case series. One-hundred eyes from 66 patients with DME were retrospectively included. OCT parameters, including central macular thickness (CMT), height of intraretinal cystoid, subretinal fluid and sponge-like retinal swelling, density of hyperreflective foci (HRF), and integrity of the ellipsoidal zone (EZ), were assessed. Correlation analyses and multiple linear regression analysis were performed to quantitatively explore the relationship between best-corrected visual acuity (BCVA) and OCT parameters. Results Among all OCT parameters, CMT, height of intraretinal cystoid, height of sponge-like retinal swelling, and density of HRF and EZ integrity were significantly correlated with BCVA (r = −0.550, −0.526, −0.411, −0.277, and −0.501, respectively; P < 0.01). In multiple linear regression analysis, CMT, density of HRF, and EZ integrity fit a significant linear equation (β = 0.482, 0.184, and 0.447, respectively), with the adjusted R square reaching 0.522 (P < 0.001). In eyes without SRF, the height of intraretinal cystoid, density of HRF, and EZ integrity were included in the model and an adjusted R square of 0.605 (P < 0.001) was obtained. Conclusion In DME eyes, OCT parameters, including the density of HRF, the EZ integrity together with CMT, or the height of intraretinal cystoid, could explain 52.2% to 60.5% of the variation in BCVA and were weighted approximately 2 : 1 : 2, respectively.
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Relationship between Serum Vascular Endothelial Growth Factor Levels and Stages of Diabetic Retinopathy and Other Biomarkers. J Ophthalmol 2020; 2020:8480193. [PMID: 32774911 PMCID: PMC7396029 DOI: 10.1155/2020/8480193] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/04/2020] [Accepted: 07/11/2020] [Indexed: 12/19/2022] Open
Abstract
Aim This study aims to measure serum vascular endothelial growth factor (VEGF) levels in a sample of Jordanian patients and to determine their relationship with the different stages of diabetic retinopathy. It also explores the correlation between VEGF concentrations and different biochemical and demographic findings. Materials and Methods A total of 167 adults participated in the study. Participants were divided into two main categories: patients with diabetes mellitus (DM) type 2 without diabetic retinopathy (DR) (N = 62) and patients with DM type 2 affected by DR (N = 105). DR patients were further subclassified into nonproliferative (N = 41) and proliferative (N = 64). Basic laboratory tests were measured to correlate with VEGF levels. Irisin, a hormone linked to diabetic retinopathy was also measured and correlated with VEGF. Results Serum VEGF was found to positively correlate with the severity of diabetic retinopathy. The means of VEGF serum concentrations were 60 pg/mL for controls, 133 pg/mL for nonproliferative DR patients, and 229 pg/mL for proliferative DR patients. We found a significant positive correlation with glycosylated hemoglobin (HbA1c), and a significant negative correlation with high-density lipoprotein (HDL) levels, age, and irisin. Conclusion In this cohort of Jordanian diabetics, serum VEGF concentrations strongly correlated with the presence and stages of diabetic retinopathy, suggesting it as an appropriate indicator for diabetic retinopathy early detection and management in this society. VEGF levels also significantly correlated with HbA1c, HDL, and irisin levels. Further studies are encouraged to explore these relationships in other ethnic groups and with different diabetic complications.
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Wang JR, Chen Z, Yang K, Yang HJ, Tao WY, Li YP, Jiang ZJ, Bai CF, Yin YC, Duan JM, Zhou YY, Geng XQ, Yang Y. Association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and diabetic retinopathy among diabetic patients without a related family history. Diabetol Metab Syndr 2020; 12:55. [PMID: 32636938 PMCID: PMC7331251 DOI: 10.1186/s13098-020-00562-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Diabetic retinopathy (DR) is a specific neurovascular complication of diabetes mellitus (DM). Clinically, family history is a widely recognized risk factor for DR, assisting diagnosis and risk strata. However, among a great amount of DR patients without hereditary history like hypertension and diabetes, direct and simple risk factors to assist clinical decisions are still required. Herein, we intend to investigate the associated risk factors for these DR patients based on systemic inflammatory response indexes, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). METHODS We consecutively enrolled 1030 patients with a definite diagnosis of type 2 diabetes mellitus (T2DM) from the endocrinology department of the Second hospital of People in Yun Nan. Based on funduscopy and family history checking, we excluded patients with a family history of hypertension and diabetes and finally enrolled 264 patients with DR and 206 patients with non-diabetic retinopathy (NDR). Through correlation analysis, univariate and multivariate regression, we further explore the association between NLR, PLR, and DR. On top of that, we investigate the effect of NLR and PLR on risk reclassification of DR. RESULTS Compared with NDR patients, NLR and PLR levels are significantly higher among DR patients (NLR: 2.36 ± 1.16 in DR group versus 1.97 ± 1.06 in NDR group, p < 0.001; PLR: 11.62 ± 4.55 in DR group versus10.56 ± 4.45 in NDR group, p = 0.012). According to univariate analysis, NLR and PLR add risks to DR. After fully adjusting co-founders, NLR, as both continuous and categorical variate, remains an independent risk factor for DR (OR (95%CI): 1.37 (1.06, 1.78) P = 0.018). And though PLR was not independently associated with DR as a continuous variable (OR (95%CI) 1.05 (0.99, 1.11) p = 0.135), the highest quantile of PLR add two-fold increased risk (OR (95%CI) 2.20 (1.05, 4.59) p = 0.037) in the fully adjusted model for DR. In addition, addition of PLR and NLR to the established factor hemoglobin (Hb) improved the discriminability of the model and assisted the reclassification of DR. After combining PLR and NLR the Area under curve (AUC) of Hb based model raised from 0.76 to 0.78, with a category-free net reclassification improvement (NRI) of 0.532 (p < 0.001) and integrated discrimination improvement (IDI) of 0.029 (p < 0.001). CONCLUSIONS Systemic inflammatory response indexes NLR and PLR were associated with the presence of DR among patients without associated family history and contributed to improvements in reclassification of DR in addition to Hb.
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Affiliation(s)
- Jin-Rui Wang
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Zhongli Chen
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 200001 Shanghai, China
| | - Ke Yang
- Department of Cardiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 200001 Shanghai, China
| | - Hui-Jun Yang
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Wen-Yu Tao
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Yi-Ping Li
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Ze-Jia Jiang
- The Second People’s Hospital of Qujing City, Yunnan Qujing, 655000 China
| | - Chao-Fang Bai
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Yue-Chuan Yin
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Jian-Mei Duan
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Yuan-Yuan Zhou
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Xin-Qian Geng
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
| | - Ying Yang
- Department of Endocrinology and Metabolism, The Second People’s Hospital of Yunnan Province, Fourth Affiliated Hospital of Kunming Medical University, Kunming, 650021 China
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Adki KM, Kulkarni YA. Potential Biomarkers in Diabetic Retinopathy. Curr Diabetes Rev 2020; 16:971-983. [PMID: 32065092 DOI: 10.2174/1573399816666200217092022] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/28/2019] [Accepted: 01/09/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diabetic retinopathy is one of the important complications of diabetes. In major cases, diabetic retinopathy is unnoticed until the irreversible damage to eye occurs and leads to blurred vision and, eventually, blindness. OBJECTIVE The pathogenesis and diagnosis of diabetic retinopathy are very complex and not fully understood. Currently, well-established laser techniques and medications are available, but these treatment options have their own shortcomings on biological systems. Biomarkers can help to overcome this problem due to easy, fast and economical options for diagnosis of diabetic retinopathy. METHODS The search terms used were "Diabetic retinopathy", "Biomarkers in diabetic retinopathy", "Novel biomarkers in diabetic retinopathy" and "Potential biomarkers of diabetic retinopathy" by using different scientific resources and databases like EBSCO, ProQuest, PubMed and Scopus. Eligibility criteria included biomarkers involved in diabetic retinopathy in the detectable range. Exclusion criteria included the repetition and duplication of the biomarker in diabetic retinopathy. RESULTS Current review and literature study revealed that biomarkers of diabetic retinopathy can be categorized as inflammatory: tumor necrosis factor-α, monocyte chemoattractant protein-1, transforming growth factor- β; antioxidant: nicotinamide adenine dinucleotide phosphate oxidase; nucleic acid: poly ADP ribose polymerase- α, Apelin, Oncofetal; enzyme: ceruloplasmin, protein kinase C; and miscellaneous: erythropoietin. These biomarkers have a great potential in the progression of diabetic retinopathy hence can be used in the diagnosis and management of this debilitating disease. CONCLUSION Above mentioned biomarkers play a key role in the pathogenesis of diabetic retinopathy; hence they can also be considered as potential targets for new drug development.
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Affiliation(s)
- Kaveri M Adki
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM'S NMIMS, V.L. Mehta Road, Vile Parle (West), Mumbai-400056, India
| | - Yogesh A Kulkarni
- Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM'S NMIMS, V.L. Mehta Road, Vile Parle (West), Mumbai-400056, India
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Cruz A, Queirós R, Abreu CM, Barata C, Fernandes R, Silva R, Ambrósio AF, Soares-dos-Reis R, Guimarães J, Sá MJ, Relvas JB, Freitas PP, Mendes Pinto I. Electrochemical Immunosensor for TNFα-Mediated Inflammatory Disease Screening. ACS Chem Neurosci 2019; 10:2676-2682. [PMID: 30985099 DOI: 10.1021/acschemneuro.9b00036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Inflammation associated with cancer, neurodegenerative, ocular, and autoimmune diseases has a considerable impact on public health. Tumor necrosis factor alpha (TNFα) is a key mediator of inflammatory responses, responsible for many of the systemic manifestations during the inflammatory process. Thus, inhibition of TNFα is a commonplace practice in the treatment of these disorders. Successful therapy requires the ability to determine the appropriate dose of anti-TNFα drugs to be administered in a timely manner, based on circulating TNFα levels. In this Letter, we report the development of an immunosensor technology able to quantify TNFα at the picogram level in relevant human body fluids, holding the potential to early detect inflammation and monitor TNFα levels during treatment, enabling TNFα-targeted treatments to be tailored according to the immune status of an individual patient. This immunosensor technology is significantly more rapid and sensitive than conventional enzyme linked immunosorbent assays, maintaining high specificity and requiring small sample volumes. These features might also be advantageous in the context of personalized medicine, as this analytical platform can deliver advanced diagnostics and reduce clinical burden.
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Affiliation(s)
- Andrea Cruz
- International Iberian Nanotechnology Laboratory, Braga 4715-330, Portugal
| | - Raquel Queirós
- International Iberian Nanotechnology Laboratory, Braga 4715-330, Portugal
| | - Catarina M. Abreu
- International Iberian Nanotechnology Laboratory, Braga 4715-330, Portugal
- Swansea University Medical School, Swansea SA2 8PP, United Kingdom
| | - Catarina Barata
- International Iberian Nanotechnology Laboratory, Braga 4715-330, Portugal
- Instituto Superior Técnico, University of Lisbon, Lisbon 1649-004, Portugal
| | - Rosa Fernandes
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra 3004-531, Portugal
- CNC.IBILI, University of Coimbra, Coimbra 3000-548, Portugal
| | - Rufino Silva
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra 3004-531, Portugal
- Coimbra University Hospital, Coimbra 3000-075, Portugal
| | - Antonio F. Ambrósio
- Coimbra Institute for Clinical and Biomedical Research, Faculty of Medicine, University of Coimbra, Coimbra 3004-531, Portugal
- CNC.IBILI, University of Coimbra, Coimbra 3000-548, Portugal
| | - Ricardo Soares-dos-Reis
- Neurology Department, Centro Hospitalar de São João, Porto 4200-319, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto 4200-135, Portugal
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto 4200-135, Portugal
| | - Joana Guimarães
- Neurology Department, Centro Hospitalar de São João, Porto 4200-319, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto 4200-135, Portugal
- Center for Drug Discovery and Innovative Medicines (MedInUP), University of Porto, Porto 4200-135, Portugal
| | - Maria José Sá
- Neurology Department, Centro Hospitalar de São João, Porto 4200-319, Portugal
- Energy, Environment and Health Research Unit (FP-ENAS), University Fernando Pessoa, Porto 4200-135, Portugal
- Faculty of Health Sciences, University Fernando Pessoa, Porto 4200-135, Portugal
| | - João B. Relvas
- Institute for Research and Innovation in Health, University of Porto, Porto 4200-135, Portugal
| | - Paulo P. Freitas
- International Iberian Nanotechnology Laboratory, Braga 4715-330, Portugal
| | - Inês Mendes Pinto
- International Iberian Nanotechnology Laboratory, Braga 4715-330, Portugal
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Serum Vascular Endothelial Growth Factor Levels Correlate with Severity of Retinopathy in Diabetic Patients: A Systematic Review and Meta-Analysis. DISEASE MARKERS 2019; 2019:9401628. [PMID: 31019585 PMCID: PMC6451802 DOI: 10.1155/2019/9401628] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/31/2018] [Accepted: 01/27/2019] [Indexed: 12/26/2022]
Abstract
Background Investigations regarding serum and plasma vascular endothelial growth factor (VEGF) levels in patients with diabetic retinopathy (DR) are conflicting. This meta-analysis is aimed at determining whether serum and plasma VEGF levels are associated with DR and its severity in diabetic patients. Methods PubMed and EMBASE were used to search for published studies, and serum and plasma VEGF levels were compared among DR, nonproliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), and nondiabetic retinopathy (NDR) patients. Standardized mean differences (SMD) and 95% confidence interval (CI) were pooled using a random effects model. Results A total of 29 studies comprising 1805 DR (or NPDR or PDR) patients and 1699 NDR patients were included. ELISA was used to evaluate serum or plasma VEGF levels in all except for two studies included in this meta-analysis. Overall, serum VEGF levels were significantly higher in DR patients (SMD: 0.74, 95% CI: 0.44-1.03) than those in NDR patients, while plasma VEGF levels were not in the comparison (SMD: 0.40, 95% CI: −0.13-0.92). Similarly, NPDR (SMD: 0.51, 95% CI: 0.22-0.80) and PDR (SMD: 1.32, 95% CI: 0.79-1.85) patients had higher serum VEGF levels compared with NDR patients, but the difference was not significant in plasma samples (SMD: 0.24, 95% CI: −0.47-0.95; SMD: 0.37, 95% CI: −0.30-1.05). In addition, serum VEGF levels were higher in PDR patients than those in NPDR patients (SMD: 0.87, 95% CI: 0.41-1.33), but plasma VEGF levels were not (SMD: −0.00, 95% CI: −0.31-0.31). The subgroup and metaregression analysis revealed that the study location, study design, and publication year of a study have certain influence on heterogeneity between studies in serum or plasma samples. Conclusions VEGF levels in the serum instead of those in the plasma correlate to the presence and severity of DR in diabetic patients. Further large-scale studies are required to confirm these findings.
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Sharif R, Bak-Nielsen S, Sejersen H, Ding K, Hjortdal J, Karamichos D. Prolactin-Induced Protein is a novel biomarker for Keratoconus. Exp Eye Res 2019; 179:55-63. [PMID: 30393162 PMCID: PMC6360109 DOI: 10.1016/j.exer.2018.10.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/15/2018] [Accepted: 10/24/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of the study was to investigate the role of Prolactin-Induced Protein (PIP) as a predictive biomarker for Keratoconus (KC). PARTICIPANTS This study included one hundred and forty-seven patients with KC (105 male, 42 female), and sixty healthy controls (27 male, 33 female). METHODS Tears, plasma and saliva samples were collected from all participants. In both KC and healthy groups all collected samples were divided into four age subgroups (15-24y), (25-34y), (35-44y) and (45y and up). Samples were analyzed using western blot (WB) and enzyme-linked immunosorbent assay (ELISA). Areas under the receiver operating characteristic curves (AUROCs) were used to evaluate diagnostic accuracy for distinguishing between KC and healthy eyes. MAIN OUTCOME MEASURES Difference in PIP protein levels between patients with KC and healthy controls. RESULTS Results showed significant downregulation of PIP expression in all three biological fluids on KC patients when compared to healthy controls, independent of age, sex and severity. Since PIP is a hormonal-regulated protein, we also investigated the expression of major sex hormones. We detected significant upregulation in salivary and plasma Dehydroepiandrosterone sulfate (DHEA-S) levels and significant downregulation of estrone and estriol levels, in KC patients compared to healthy controls, independent of sex, age, and KC severity stage. ROC was used to determine the overall predictive accuracy of this protein in KC. Data showed an area under the curve (AUC) for PIP in tears of 0.937 (95%CI: 0.902-0.971), in plasma of 0.928 (95%CI: 0.890-0.968) and in saliva of 0.929 (95%CI: 0.890-0.968). CONCLUSIONS Conclusively, our results show that PIP levels are reduced in all three human biological fluids tested, and may independently or in combination with current imaging techniques aid in screening and diagnosis of KC. Our data revealed that PIP levels can potentially differentiate between disease and healthy cases, and PIP levels are stable in relation to KC severity, sex and age. Moreover, alterations in sex hormone levels in correlation with reduced PIP levels in KC provide an intriguing insight in the underlying KC pathophysiology and highlights the role of PIP as a KC biomarker.
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Affiliation(s)
- Rabab Sharif
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
| | - Sashia Bak-Nielsen
- Department of Ophthalmology, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus, Denmark.
| | - Henrik Sejersen
- Department of Ophthalmology, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus, Denmark.
| | - Kai Ding
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences, Oklahoma City, OK, 73104, USA
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Noerrebrogade 44, 8000, Aarhus, Denmark.
| | - Dimitrios Karamichos
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA; Department of Ophthalmology/Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
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22
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Zhong L, Liu Y, Wang K, He Z, Gong Z, Zhao Z, Yang Y, Gao X, Li F, Wu H, Zhang S, Chen L. Biomarkers: paving stones on the road towards the personalized precision medicine for oral squamous cell carcinoma. BMC Cancer 2018; 18:911. [PMID: 30241505 PMCID: PMC6151070 DOI: 10.1186/s12885-018-4806-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 09/06/2018] [Indexed: 12/20/2022] Open
Abstract
Traditional therapeutics have encountered a bottleneck caused by diagnosis delay and subjective and unreliable assessment. Biomarkers can overcome this bottleneck and guide us toward personalized precision medicine for oral squamous cell carcinoma. To achieve this, it is important to efficiently and accurately screen out specific biomarkers from among the huge number of molecules. Progress in omics-based high-throughput technology has laid a solid foundation for biomarker discovery. With credible and systemic biomarker models, more precise and personalized diagnosis and assessment would be achieved and patients would be more likely to be cured and have a higher quality of life. However, this is not straightforward owing to the complexity of molecules involved in tumorigenesis. In this context, there is a need to focus on tumor heterogeneity and homogeneity, which are discussed in detail. In this review, we aim to provide an understanding of biomarker discovery and application for precision medicine of oral squamous cell carcinoma, and have a strong belief that biomarker will pave the road toward future precision medicine.
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Affiliation(s)
- Liang Zhong
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Yutong Liu
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Kai Wang
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Zhijing He
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Zhaojian Gong
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Zhili Zhao
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Yaocheng Yang
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Xiaofei Gao
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Fangjie Li
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Hanjiang Wu
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China
| | - Sheng Zhang
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China.
| | - Lin Chen
- Department of Oral and Maxillofacial Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, People's Republic of China.
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23
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Niranjan G, Srinivasan AR, Srikanth K, Pruthu G, Reeta R, Ramesh R, Anitha R, Mohana Valli V. Evaluation of Circulating Plasma VEGF-A, ET-1 and Magnesium Levels as the Predictive Markers for Proliferative Diabetic Retinopathy. Indian J Clin Biochem 2018; 34:352-356. [PMID: 31391728 DOI: 10.1007/s12291-018-0753-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 04/12/2018] [Indexed: 12/15/2022]
Abstract
Diabetic retinopathy (DR) is the most common cause for preventable blindness in India. The onset of micro and macrovascular complications in T2DM is multifactorial and difficult to predict. The status of micronutrients, several inflammatory cytokines, elevated triacylglycerols, oxidative stress etc., are being studied extensively. Hypomagnesemia plays a pivotal role in worsening of insulin resistance. Although, Vascular Endothelial Growth Factor-A (VEGF-A) and Endothelin-1 (ET-1) are known to be elevated in DR, yet few reports cite their role, especially in Indian population. In this study, we included thirty subjects with T2DM in each of the three groups namely, T2DM cases without retinopathy, Non Proliferative DR (NPDR) and Proliferative DR (PDR) retinopathy. The glycemic status, circulating plasma VEGF-A, ET-1 levels, serum magnesium and lipids were estimated and compared among the groups. An ROC was drawn to evaluate VEGF-A, ET-1 and serum magnesium levels as the predictive markers for PDR. On comparison VEGF-A, ET-1 and serum magnesium levels showed a significant difference among the three groups. PDR cases had higher circulating levels of VEGF-A, ET-1 and low serum magnesium levels when compared to others. ROC for VEGF-A and ET-1 showed an optimum cut-off of 1521 ng/ml (AUC 0.975) and 16 pg/ml (AUC 0.96) respectively. A negative ROC was drawn to check the lower cut-off limit for serum magnesium; we documented an optimum cut off of 1.7 mg/dl (AUC 0.837). ET-1, VEGF-A and serum Magnesium levels are significantly altered in PDR and can be used as the predictive markers of PDR.
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Affiliation(s)
- Gopal Niranjan
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
| | - A R Srinivasan
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
| | - K Srikanth
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
| | - Gowda Pruthu
- Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
| | - R Reeta
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
| | - Ramasamy Ramesh
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
| | - Rajendiran Anitha
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
| | - V Mohana Valli
- Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute (MGMC & RI), SBV, Pillaiyarkuppam, Puducherry 607 402 India
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24
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Rapino C, Tortolani D, Scipioni L, Maccarrone M. Neuroprotection by (endo)Cannabinoids in Glaucoma and Retinal Neurodegenerative Diseases. Curr Neuropharmacol 2018; 16:959-970. [PMID: 28738764 PMCID: PMC6120105 DOI: 10.2174/1570159x15666170724104305] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/14/2017] [Accepted: 07/21/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Emerging neuroprotective strategies are being explored to preserve the retina from degeneration, that occurs in eye pathologies like glaucoma, diabetic retinopathy, age-related macular degeneration, and retinitis pigmentosa. Incidentally, neuroprotection of retina is a defending mechanism designed to prevent or delay neuronal cell death, and to maintain neural function following an initial insult, thus avoiding loss of vision. METHODS Numerous studies have investigated potential neuroprotective properties of plant-derived phytocannabinoids, as well as of their endogenous counterparts collectively termed endocannabinoids (eCBs), in several degenerative diseases of the retina. eCBs are a group of neuromodulators that, mainly by activating G protein-coupled type-1 and type-2 cannabinoid (CB1 and CB2) receptors, trigger multiple signal transduction cascades that modulate central and peripheral cell functions. A fine balance between biosynthetic and degrading enzymes that control the right concentration of eCBs has been shown to provide neuroprotection in traumatic, ischemic, inflammatory and neurotoxic damage of the brain. RESULTS Since the existence of eCBs and their binding receptors was documented in the retina of numerous species (from fishes to primates), their involvement in the visual processing has been demonstrated, more recently with a focus on retinal neurodegeneration and neuroprotection. CONCLUSION The aim of this review is to present a modern view of the endocannabinoid system, in order to discuss in a better perspective available data from preclinical studies on the use of eCBs as new neuroprotective agents, potentially useful to prevent glaucoma and retinal neurodegenerative diseases.
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Affiliation(s)
- Cinzia Rapino
- Address correspondence to these authors at the Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; Tel: +39 0861 266842;, E-mail: and the Department of Medicine, Campus Bio-Medico University of Rome, 00128 Rome, Italy; Tel: +39 06 225419169;, E-mail:
| | | | | | - Mauro Maccarrone
- Address correspondence to these authors at the Faculty of Veterinary Medicine, University of Teramo, 64100 Teramo, Italy; Tel: +39 0861 266842;, E-mail: and the Department of Medicine, Campus Bio-Medico University of Rome, 00128 Rome, Italy; Tel: +39 06 225419169;, E-mail:
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