Dietary glutamic acid and aspartic acid as biomarkers for predicting diabetic retinopathy

Park, So Young; Kim, Jieun; Son, Jung Il; Rhee, Sang Youl; Kim, Do-Yeon; Chon, Suk; Lim, Hyunjung; Woo, Jeong-Taek

doi:10.1038/s41598-021-83165-5

Cited by 11 publications

(7 citation statements)

References 28 publications

(18 reference statements)

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“…Most observational studies measured the dietary intake using standard dietary methods such as 24 h recall (n = 4) [ 20 , 34 , 35 ], food frequency questionnaires (FFQ) (n = 23) [ 12 , 18 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ], or 3-day food records (n = 3) [ 17 , 51 , 52 ]. A general-based interviewer-administered questionnaire was administered in 20 observational studies, and only one study evaluated dietary sodium intake from urinary excretion levels.…”

Section: Resultsmentioning

confidence: 99%

“…A prospective study by Park and colleagues found that the intake of glutamic acid and aspartic acid did not affect DR incidence [ 51 ]. Still, lower intake of aspartic acid showed an increased proliferative DR incidence, and the result remained consistent after adjustment (intake of aspartic acid in the highest tertile vs. lowest tertile for PDR, HR: 0.39, 95%CI: 0.16–0.96, p = 0.013) [ 51 ]. Another prospective study by Cundiff and colleagues showed that increased intake of proteins lowered progression of DR risk.…”

Section: Resultsmentioning

confidence: 99%

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Dietary Intake and Diabetic Retinopathy: A Systematic Review of the Literature

et al. 2022

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Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus. The evidence connecting dietary intake and DR is emerging, but uncertain. We conducted a systematic review to comprehensively summarize the current understanding of the associations between dietary consumption, DR and diabetic macular edema (DME). We systematically searched PubMed, Embase, Medline, and the Cochrane Central Register of Controlled Trials between January 1967 to May 2022 for all studies investigating the effect of diet on DR and DME. Of the 4962 articles initially identified, 54 relevant articles were retained. Our review found that higher intakes of fruits, vegetables, dietary fibers, fish, a Mediterranean diet, oleic acid, and tea were found to have a protective effect against DR. Conversely, high intakes of diet soda, caloric intake, rice, and choline were associated with a higher risk of DR. No association was seen between vitamin C, riboflavin, vitamin D, and milk and DR. Only one study in our review assessed dietary intake and DME and found a risk of high sodium intake for DME progression. Therefore, the general recommendation for nutritional counseling to manage diabetes may be beneficial to prevent DR risk, but prospective studies in diverse diabetic populations are needed to confirm our findings and expand clinical guidelines for DR management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Dietary Intake and Diabetic Retinopathy: A Systematic Review of the Literature

et al. 2022

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“…Glu is associated with T2D, and studies have shown a 0.25 drop in Glu levels in diabetic subjects compared to non-diabetic controls ( 23 ). At the same time, studies have found that Glu is a risk factor for the incidence of DR ( 24 ), while another Korean study found that the intake of Glu did not affect the incidence of DR ( 25 ). We believe that in addition to the heterogeneity of the population, the metabolic interactions between amino acids should also be taken into account.…”

Section: Discussionmentioning

confidence: 99%

A new predictive model for the concurrent risk of diabetic retinopathy in type 2 diabetes patients and the effect of metformin on amino acids

Song

Luo²,

Huang³

et al. 2022

Front. Endocrinol.

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ObjectiveThis study established a model to predict the risk of diabetic retinopathy (DR) with amino acids selected by partial least squares (PLS) method, and evaluated the effect of metformin on the effect of amino acids on DR in the model.MethodsIn Jinzhou, Liaoning Province, China, we retrieved 1031 patients with type 2 diabetes (T2D) from the First Affiliated Hospital of Liaoning Medical University. After sorting the amino acids using the PLS method, the top 10 amino acids were included in the model. Multivariate logistic regression was used to analyze the relationship between different amino acids and DR. And then the effects of metformin on amino acids were explored through interaction. Finally, Spearman’s rank correlation analysis was used to analyze the correlation between different amino acids.ResultsAfter sorting by PLS, Gly, Pro, Leu, Lyr, Glu, Phe, Tyr, His, Val and Ser were finally included in the DR risk prediction model. The predictive model after adding amino acids was statistically different from the model that only included traditional risk factors (p=0.001). Metformin had a significant effect on the relationship between DR and 7 amino acids (Gly, Glu, Phe, Tyr, His, Val, Ser, p<0.05), and the population who are not using metformin and have high levels of Glu (OR: 0.44, 95%CI: 0.27-0.71) had an additive protection effect for the occurrence of DR. And the similar results can be seen in high levels of Gly (OR: 0.46, 95%CI: 0.29-0.75), Leu (OR: 0.48, 95%CI: 0.29-0.8), His (OR: 0.46, 95%CI: 0.29-0.75), Phe (OR: 0.24, 95%CI: 0.14-0.42) and Tyr (OR: 0.41, 95%CI: 0.24 -0.68) in population who are not using metformin.ConclusionsWe established a prediction model of DR by amino acids and found that the use of metformin reduced the protective effect of amino acids on DR developing, suggesting that amino acids as biomarkers for predicting DR would be affected by metformin use.

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“…Based on two different cohorts, Cheng et al report that plasma glutamate is related to insulin resistance and can be applied to predict DR ( 20 ). However, the predictive value of dietary glutamate is unsatisfactory ( 21 ), which implies that plasma glutamate may not relate to dietary habits. Moreover, Simo et al ( 7 ) report that increased glutamate can trigger vascular endothelial growth factor activation, which contributes to microangiopathy and results in DR.…”

Section: Discussionmentioning

confidence: 99%

“…It is further demonstrated as a potentially valuable biomarker for screening DR from type 2 diabetic (T2D) patients in another metabolomic research ( 20 ). However, the intake of dietary glutamate does not affect DR occurrence according to a Korea National Diabetes Program cohort study ( 21 ). Furthermore, existing evidence suggests that glutamate excitotoxicity has a pivotal role in the pathogenesis of retinal neurodegeneration, which is one of the symbolic characteristics during the early transformation of DR ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Individual and joint effects of trehalose and glutamate on diabetic retinopathy: a propensity score-matched case–control study

Guo

et al. 2022

Endocrine Connections

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Although previous studies demonstrate that trehalose can help maintain glucose homeostasis in healthy humans, its role and joint effect with glutamate on diabetic retinopathy (DR) remain unclear. We aimed to comprehensively quantify the associations of trehalose and glutamate with DR. This study included 69 pairs of DR and matched type 2 diabetic (T2D) patients. Serum trehalose and glutamate were determined via ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry system. Covariates were collected by a standardized questionnaire, clinical examinations and laboratory assessments. Individual and joint association of trehalose and glutamate with DR were quantified by multiple conditional logistic regression models. The adjusted odds of DR averagely decreased by 86% [odds ratio (OR): 0.14; 95% confidence interval (CI): 0.06,0.33] with per interquartile range increase of trehalose. Comparing with the lowest quartile, adjusted OR (95% CI) were 0.20 (0.05,0.83), 0.14 (0.03,0.63) and 0.01 (<0.01,0.05) for participants in the 2nd, 3rd and 4th quartiles of trehalose, respectively. In addition, as compared to their counterparts, T2D patients with lower trehalose (<median) and higher glutamate (≥ median) had the highest odds of DR (OR: 36.81; 95% CI: 6.75, 200.61). Apparent super-multiplicative effect of trehalose and glutamate on DR was observed, whereas relative excess risk due to interaction (RERI) was not significant. The study suggests that trehalose is beneficial to inhibit the occurrence of DR and synergistically decreases the risk of DR with reduced glutamate. Our findings also provide new insights into the mechanisms of DR and further longitudinal studies are required to confirm these findings.

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Dietary glutamic acid and aspartic acid as biomarkers for predicting diabetic retinopathy

Cited by 11 publications

References 28 publications

Dietary Intake and Diabetic Retinopathy: A Systematic Review of the Literature

Dietary Intake and Diabetic Retinopathy: A Systematic Review of the Literature

A new predictive model for the concurrent risk of diabetic retinopathy in type 2 diabetes patients and the effect of metformin on amino acids

Individual and joint effects of trehalose and glutamate on diabetic retinopathy: a propensity score-matched case–control study

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