Low bilirubin levels are an independent risk factor for diabetic retinopathy and nephropathy in Japanese patients with type 2 diabetes

Abstract Introduction:Diabetic retinopathy (DR), as a serious and specific neurovascular complication of DM, remains the leading cause of vision loss and preventable blindness in adults aged 20–74 years. Several studies have indicated that chronic inflammation plays an important role in DR. Emerging evidence suggests that the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are novel potential markers of inflammatory responses. However, only a few articles have evaluated the association between these factors and DR.Patients and Methods: The study included 133 patients diagnosed with type 2 diabetes mellitus (T2DM). Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale.Results:The mean NLR, PLR and MLR were significantly higher in patients with DR than in patients without DR (p < 0.001, p = 0.002, and p = 0.003, respectively). In the post hoc analysis, the PDR group had the highest NLR and MLR values among the three groups. Multiple logistic regression showed that the PLR was an independent risk factor for DR (odds ratio [OR]: 1.022, 95% confidence interval [CI]: 1.005–1.040 p = 0.013). Based on the receiver operating characteristic (ROC) curve, the cutoff value of PLR as an indicator for DR diagnosis was projected to be 78.70 and yielded a sensitivity and specificity of 80.7% and 48.9%, respectively, with an area under the curve of 0.669 (95% CI: 0.572–0.765, P = 0.002).Conclusions:Our results suggest that PLR may be an independent risk factor for evaluating DR in patients with type 2 diabetes.

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Serum Antithyroglobulin Antibody Levels Are Associated with Diabetic Retinopathy among Euthyroid Type 2 Diabetes Patients: A Hospital-Based, Retrospective Study

Journal of Diabetes Research ◽

10.1155/2022/2552186 ◽

2022 ◽

Vol 2022 ◽

pp. 1-10

Author(s):

Xiaotong Gao ◽

Xichang Wang ◽

Yifan Zhong ◽

Lei Liu ◽

Weiping Teng ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Risk Factor ◽

Independent Risk Factor ◽

Reference Interval ◽

Free Triiodothyronine ◽

Thyroglobulin Antibody ◽

Fundus Photographs ◽

Antibody Levels

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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A Higher Serum Calcium Level is an Independent Risk Factor for Vision-Threatening Diabetic Retinopathy in Patients with Type 2 Diabetes: Cross-Sectional and Longitudinal Analyses

Endocrine Practice ◽

10.1016/j.eprac.2021.05.003 ◽

2021 ◽

Author(s):

Yanan Hu ◽

Chuandi Zhou ◽

Ya Shi ◽

Xinping She ◽

Shuzhi Zhao ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Risk Factor ◽

Serum Calcium ◽

Calcium Level ◽

Serum Calcium Level ◽

Independent Risk Factor ◽

Longitudinal Analyses ◽

Cross Sectional

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Genome-Wide Association Studies Identify Two Novel Loci Conferring Susceptibility to Diabetic Retinopathy in Japanese Patients with Type 2 Diabetes

Human Molecular Genetics ◽

10.1093/hmg/ddab044 ◽

2021 ◽

Author(s):

Minako Imamura ◽

Atsushi Takahashi ◽

Masatoshi Matsunami ◽

Momoko Horikoshi ◽

Minoru Iwata ◽

...

Keyword(s):

Type 2 Diabetes ◽

Diabetic Retinopathy ◽

Association Studies ◽

Meta Analysis ◽

Japanese Patients ◽

Genome Wide Association ◽

Genome Wide Association Studies ◽

Genome Wide ◽

Stage 1

Abstract Several reports have suggested that genetic susceptibility contributes to the development and progression of diabetic retinopathy. We aimed to identify genetic loci that confer susceptibility to diabetic retinopathy in Japanese patients with type 2 diabetes. We analysed 5 790 508 single nucleotide polymorphisms (SNPs) in 8880 Japanese patients with type 2 diabetes, 4839 retinopathy cases and 4041 controls, as well as 2217 independent Japanese patients with type 2 diabetes, 693 retinopathy cases, and 1524 controls. The results of these two genome-wide association studies (GWAS) were combined with an inverse variance meta-analysis (Stage-1), followed by de novo genotyping for the candidate SNP loci (p < 1.0 × 10−4) in an independent case–control study (Stage-2, 2260 cases and 723 controls). After combining the association data (Stage-1 and -2) using meta-analysis, the associations of two loci reached a genome-wide significance level: rs12630354 near STT3B on chromosome 3, p = 1.62 × 10−9, odds ratio (OR) = 1.17, 95% confidence interval (CI) 1.11–1.23, and rs140508424 within PALM2 on chromosome 9, p = 4.19 × 10−8, OR = 1.61, 95% CI 1.36–1.91. However, the association of these two loci were not replicated in Korean, European, or African American populations. Gene-based analysis using Stage-1 GWAS data identified a gene-level association of EHD3 with susceptibility to diabetic retinopathy (p = 2.17 × 10−6). In conclusion, we identified two novel SNP loci, STT3B and PALM2, and a novel gene, EHD3, that confers susceptibility to diabetic retinopathy; however, further replication studies are required to validate these associations.

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