The relationship between advanced glycation end products and ocular circulation in type 2 diabetes

J Diabetes Complications. 2016 Sep-Oct;30(7):1371-7. doi: 10.1016/j.jdiacomp.2016.04.024. Epub 2016 May 4.

Abstract

Aims: To determine whether skin autofluorescence (SAF) and serum pentosidine, biomarkers of advanced glycation end products (AGEs), were associated with ocular microcirculation in type 2 diabetes patients with early diabetic retinopathy (DR).

Methods: This study included 46 eyes of 46 type 2 diabetes patients with no DR or non-proliferative DR. SAF was measured with an autofluorescence reader. Optic nerve head (ONH) microcirculation, represented by mean blur rate (MBR), was measured with laser speckle flowgraphy. Overall MBR, vascular MBR, and tissue MBR were calculated in software. MBR, SAF, pentosidine levels, and clinical findings, including central macular thickness (CMT), were then compared.

Results: SAF in the diabetes patients was correlated with age (P=0.018). Serum pentosidine was correlated with age, vascular MBR and tissue MBR (P=0.046, P=0.035, and P=0.01, respectively). CMT was correlated with tissue MBR (P=0.016), but not with vascular MBR or overall MBR. Separate multiple regression analyses of independent contributing factors revealed that age, SAF, serum pentosidine, duration of diabetes, and pulse rate contributed to tissue MBR (P=0.041, P=0.046, P=0.022, P=0.011 and P=0.036, respectively), while SAF, HbA1c, pulse rate, tissue MBR, diastolic blood pressure, and creatinine contributed to CMT (P=0.005, P=0.039, P<0.001, P<0.001, P=0.022 and P=0.001, respectively).

Conclusions: Tissue MBR may be closely related to AGE levels and CMT in type 2 diabetes patients with early DR, suggesting that ocular circulation might be potential early biomarkers of DR.

Keywords: AGE; Diabetic macular edema; Diabetic retinopathy; Pentosidine; Skin autofluorescence.

MeSH terms

  • Adult
  • Arginine / analogs & derivatives
  • Arginine / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Retinopathy / physiopathology*
  • Female
  • Glycation End Products, Advanced / blood*
  • Humans
  • Laser-Doppler Flowmetry
  • Lysine / analogs & derivatives
  • Lysine / blood
  • Male
  • Microcirculation*
  • Middle Aged
  • Optic Disk / blood supply*
  • Optical Imaging
  • Skin

Substances

  • Glycation End Products, Advanced
  • Arginine
  • pentosidine
  • Lysine