Evaluation of retinal structure and function in prediabetes

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-10-01 DOI:10.1016/j.deman.2023.100154

Angelica Echiverri, Wendy W. Harrison

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引用次数: 1

Abstract

Purpose

Alterations in retinal structure and function have been well documented in type 2 diabetes (T2DM). However, few studies have evaluated the eye in prediabetes (preDM), a precursor to T2DM. It is unknown which retinal deficits, if any, occur before T2DM diagnosis. This study evaluates retinal structure via optical coherence tomography (OCT) and retinal function via multifocal electroretinogram (mfERG) N1 and P1 in those with PreDM. The goal is to evaluate associations between structure and function across glucose dysfunction.

Methods

85 subjects (aged 28–69yrs) were tested with VERIS mfERG and Heidelberg Spectralis OCT. Demographic and health information was collected. Subjects were grouped by HbA1c: 33 controls (HbA1c <5.7%), 31 with preDM (HbA1c 5.7–6.4%), and 21 with T2DM (HbA1c >6.4% at the time of testing or diagnosed by physician) and mild or no retinopathy. mfERG N1 and P1 latency and amplitude were measured for the right eye in the foveal hexagon (central 2.4°). Average macular thickness was also measured over the central 3.3°. Groups were compared with ANOVA and corrected t-tests. Models of these associations with diabetes diagnosis (in groups above) were created with backward multivariate regression.

Results

The T2DM group was exceptionally well-controlled with an HbA1c of 7.0% ± 0.68 but also had elevated systolic blood pressure compared to other groups (P<0.01). The age of the control group was younger (P<0.01), so other testing was age controlled. There was a borderline but statistically significant difference in P1 between the control group and both the preDM and T2DM groups after Bonferroni corrections (P<0.03). There was also a difference in N1 latency between the control and other groups (P<0.001). A multivariate model demonstrated a significant relationship between T2DM/PreDM diagnosis and delayed N1 latency, reduced foveal thickness, and age.

Conclusions

Structure and function together can provide an associative model of preDM or T2DM changes for patients. Based on this multivariate model, N1 is strongly associated with preDM and T2DM. N1 findings and decreasing foveal thickness are additive and can together inform ocular health related to preDM. Future longitudinal studies are needed to understand changes in function and structure in preDM and T2DM.

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糖尿病前期视网膜结构和功能的评价

目的:2型糖尿病(T2DM)患者视网膜结构和功能的改变已被充分证实。然而，很少有研究评估糖尿病前期(preDM)的眼睛，这是2型糖尿病的前兆。目前尚不清楚在诊断T2DM之前是否存在视网膜缺陷。本研究通过光学相干断层扫描(OCT)评估PreDM患者的视网膜结构，并通过多焦视网膜电图(mfERG) N1和P1评估视网膜功能。目的是评估结构和功能之间的联系在葡萄糖功能障碍。方法采用VERIS mfERG和Heidelberg Spectralis oct检测85例(28 ~ 69岁)，收集人口统计学和健康信息。受试者按HbA1c分组:33名对照组(HbA1c <5.7%)， 31名糖尿病前期患者(HbA1c 5.7-6.4%)， 21名T2DM患者(检测或医生诊断时HbA1c < 6.4%)，轻度或无视网膜病变。测量右眼中央凹六边形(中央2.4°)mfERG N1和P1潜伏期和振幅。平均黄斑厚度也测量在中心3.3°。各组间比较采用方差分析和校正t检验。这些与糖尿病诊断相关的模型(在上述组中)通过反向多元回归建立。结果T2DM组控制异常良好，HbA1c为7.0%±0.68，但收缩压较其他组升高(P<0.01)。对照组年龄偏小(P<0.01)，其他检验均为年龄对照。经Bonferroni校正后，对照组与preDM组和T2DM组的P1有临界差异，但有统计学意义(P<0.03)。对照组和其他组之间N1潜伏期也存在差异(P<0.001)。一个多变量模型显示T2DM/PreDM诊断与延迟的N1潜伏期、减少的中央凹厚度和年龄有显著关系。结论结构和功能共同提供了糖尿病前期或T2DM患者变化的关联模型。基于这个多变量模型，N1与前期糖尿病和T2DM密切相关。N1的发现和下降的中央凹厚度是叠加的，可以共同告知与preDM相关的眼部健康。未来的纵向研究需要了解糖尿病前期和T2DM的功能和结构的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.