Endocrine Abstracts

Background: Diabetic retinopathy is a common complication of diabetes mellitus and the leading cause of blindness in the working-age population in the developed world. Novel biomarkers are needed to improve the screening efficiency for the prevention and early treatment of this condition. Accumulation of advanced glycation end products (AGEs) is considered as one of pathogenetic pathways in development of diabetic complications. AGEs are formed in the process of non-enzymatic glycation of proteins. AGEs assessment could represent a long-term memory of prolonged hyperglycemia and could be an important biomarker in diabetic retinopathy.

Aim: The aim of the current study was to compare AGEs risk groups in patients with different stages of diabetic retinopathy in Latvia.

Methods: Altogether 115 patients with type 1 diabetes and type 2 diabetes were enrolled in the study. Patients were stratified into three groups according to the severity of diabetic retinopathy: “no retinopathy” group; “non-proliferative retinopathy” included patients with mild, moderate and severe non-proliferative retinopathy; group of “proliferative retinopathy” included patients with non-high and high risk proliferative retinopathy and status post laser-photocoagulation. AGEs risk groups (0- normal, 1- mild risk, 2- intermediate risk, 3- high risk) were determined using AGE reader (Diagnoptics). Statistical analysis was performed using programme R: Wilcoxon, Kruskal-Wallis, Fisher, Chi-square test, Kendall’s T test and Spearman’s correlation.

Results: Subjects in the group of “no retinopathy” (n=57) compared to “non-proliferative retinopathy” (n=29) and “proliferative retinopathy” (n=29) were statistically significantly older, had shorter duration of diabetes, higher prevalence of type 2 diabetes, lower HbA1c and low density lipoprotein levels, less diabetic maculopathy cases. In the group of proliferative retinopathy there was a higher albumin/creatinine ratio in urine. AGEs risk groups were statistically significantly related with the presence and severity of diabetic retinopathy (P=0.000) and also moderately positively correlated with the progression of diabetic retinopathy (Spearman correlation=0.438).

Conclusion: In this study, we demonstrated differences in AGEs risk groups between patients with different stages of diabetic retinopathy in Latvia. AGEs risk group could be used as one of non-invasive biomarkers of diabetic retinopathy.

Acknowledgements: The work was supported by the Baltic Research Programme of the European Economic Area (EEA) grants, project Integrated model for personalized diabetic retinopathy screening and monitoring using risk-stratification and automated AI-based fundus image analysis (PerDiRe), ID No.: EEA-RESEARCH-60.