Preventable risk factors for type 2 diabetes can be detected using noninvasive spontaneous electroretinogram signals

PLoS One. 2023 Jan 12;18(1):e0278388. doi: 10.1371/journal.pone.0278388. eCollection 2023.

Abstract

Given the ever-increasing prevalence of type 2 diabetes and obesity, the pressure on global healthcare is expected to be colossal, especially in terms of blindness. Electroretinogram (ERG) has long been perceived as a first-use technique for diagnosing eye diseases, and some studies suggested its use for preventable risk factors of type 2 diabetes and thereby diabetic retinopathy (DR). Here, we show that in a non-evoked mode, ERG signals contain spontaneous oscillations that predict disease cases in rodent models of obesity and in people with overweight, obesity, and metabolic syndrome but not yet diabetes, using one single random forest-based model. Classification performance was both internally and externally validated, and correlation analysis showed that the spontaneous oscillations of the non-evoked ERG are altered before oscillatory potentials, which are the current gold-standard for early DR. Principal component and discriminant analysis suggested that the slow frequency (0.4-0.7 Hz) components are the main discriminators for our predictive model. In addition, we established that the optimal conditions to record these informative signals, are 5-minute duration recordings under daylight conditions, using any ERG sensors, including ones working with portative, non-mydriatic devices. Our study provides an early warning system with promising applications for prevention, monitoring and even the development of new therapies against type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2* / diagnosis
  • Diabetic Retinopathy* / diagnosis
  • Diabetic Retinopathy* / prevention & control
  • Electroretinography / methods
  • Humans
  • Obesity
  • Risk Factors

Grants and funding

R.N.I. is a Doctoral student from the Programa de Posgrado en Ciencias, Universidad Nacional Autónoma de México (UNAM) and received fellowships from the National Council of Science and Technology of Mexico (CONACYT; #620199) and from UNAM DGAPA-PAPIIT #070122 and #189522. This study was supported by the UNAM grant IN209317 (ST), IN205420 (ST), CONACYT 299625 (ST), CONACYT CF-2019-1759 (ST), and Shedid grant (R. Miledí and A. Martínez Torres, acknowledgement since there are not co-authors). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.