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Transthyretin and retinol-binding protein as discriminators of diabetic retinopathy in type 1 diabetes mellitus

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Abstract

Purpose

Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus (DM), which is still a major reason for blindness. Transthyretin (TTR) and retinol-binding protein (RBP) are thought to be related to the pathogenesis both in T2DM and T1DM. We aimed to investigate the association between serum levels of TTR, RBP, RBP/TTR ratio, and DR.

Methods

This retrospective study involved 188 T1DM inpatients divided into two groups: patients with DR (n = 95) and patients without DR (n = 93). Data of serum levels on lipids and inflammation were collected. Multiple logistic regression analysis was performed to research the association between TTR, RBP, RBP/TTR, and diabetic retinopathy in T1DM.

Results

Compared with patients without DR, those with DR have a higher level of TTR (207 versus 195 mg/L, p = 0.034) and RBP4 (36.85 versus 25.68 mg/L, p < 0.001). Significant differences were also observed between two groups with respect to body mass index (BMI), blood pressure (BP), total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), homocysteine, apolipoprotein B (APOB), leucocyte, monocyte, neutrophil, and uric acid (p < 0.05 for all). TTR, RBP, and RBP/TTR were positively correlated with BP, BMI, TG, LDL, homocysteine, APOB, and uric acid. A multivariate logistic regression model revealed individuals with RBP4 level in the highest quartile had 58.95 times higher risk of developing diabetic retinopathy than those in the lowest quartile.

Conclusions

In conclusion, TTR, RBP, and RBP/TTR ratio are risk factors of DR in T1DM. They are potential markers and targets for diagnosis and treatment of DR.

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Funding

This work was supported by grants from the Shandong Key R&D Program (Grant No. 2017GSF18129), the National Key Research and Development Plan (Grant No. 2017YFC1309805), the National Natural Science Foundation of China (Grant No. 82170860), the Special Fund for Clinical Medical Science Research of the Chinese Medical Association (Grant No. 12020330323), and the Medical Quality Management Project of Shandong Province (2016).

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Author notes

  1. Weixia Sun and Yingzhou Shi contributed equally to the article.

Authors and Affiliations

  1. Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 324 Jingwu Road, Jinan, 250021, Shandong, China

    Weixia Sun, Yingzhou Shi, Jiaxuan Yang, Xiaojun Song, Yajuan Zhang, Wendi Zhang & Xinli Zhou

  2. Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China

    Weixia Sun, Yingzhou Shi, Jiaxuan Yang, Xiaojun Song, Yajuan Zhang, Wendi Zhang & Xinli Zhou

  3. Shandong Clinical Medical Center of Endocrinology and Metabolism, Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, China

    Weixia Sun, Yingzhou Shi, Jiaxuan Yang, Xiaojun Song, Yajuan Zhang, Wendi Zhang & Xinli Zhou

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  1. Weixia Sun
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Correspondence to Xinli Zhou.

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Sun, W., Shi, Y., Yang, J. et al. Transthyretin and retinol-binding protein as discriminators of diabetic retinopathy in type 1 diabetes mellitus. Int Ophthalmol 42, 1041–1049 (2022). https://doi.org/10.1007/s10792-021-02088-2

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