Endocrine Abstracts

Background: Diabetic retinopathy (DR) is one of the most common complication of diabetes and it has a significant impact on national and global health. Accumulation of advanced glycation endproducts (AGE) is recognized as a contributing factor in the development of diabetic complications. The evaluation of AGE has the potential to be an important biomarker in DR, reflecting the impact of prolonged high glucose levels on long-term metabolic memory.

Aim: The objective of this pilot study was to assess and compare the risk levels of AGE among patients at various stages of DR in Latvia.

Methods: In the study 72 participants with type 1 or type 2 diabetes were included. They were grouped based on the severity of their DR: "no retinopathy", "non-proliferative retinopathy", and the "proliferative retinopathy" group, which included also those who had undergone laser-photocoagulation treatment. The evaluation of AGE scores was performed noninvasively using an AGE reader from Diagnoptics, which measures tissue fluorescence. Subsequently, a formula was applied to derive continuous results without categorizing individuals into distinct AGE risk groups (AGE z-score=AGE mean–(0.024*age, years+0.83)). Statistical analysis was conducted using Fisher’s exact test, the Kruskal-Wallis test, and logistic regression models implemented in the R statistical software.

Results: Subjects in the group of ‘no retinopathy’ (n=37) compared to ‘non-proliferative retinopathy’ (n=22) and ‘proliferative retinopathy’ (n=13) were statistically significantly (P<0.05) with more prevalent type 2 diabetes, had shorter duration of diabetes, less diabetic neuropathy cases, higher BMI, lower HbA1c and lower AGE z-score. AGE z-score was statistically significantly (P=0.0019) related to the presence and severity of DR. In 4 of these patients, it was observed that a year ago they had a higher AGE z-score. The multivariable-adjusted odds ratios of any DR across AGE quartiles were 1.00, 9.93 (95% confidence interval [CI] 2.12-64.06), 0.88 (95%CI 0.20–3.92) and 3.42 (95%CI 0.76–20.29). The employed variables included age, HbA1c, gender, type of diabetes and the duration of diabetes.

Conclusion: In this pilot study we illustrated the association between the second quartile of AGE z-score and the odds of any stage of DR. Analysis with larger sample size is planned in our study soon.

Acknowledgements: Project PerDiRe, ID No.:EEA-RESEARCH-60.