Interrelationship of elevated serum Advanced Glycation End-product levels and malnutrition (Subjective Global Assessment) scores with the severity of retinopathy in type II diabetes

Sharma, Yashodhara; Saxena, Sandeep; Saxena, Anita; Mishra, Arvind; Natu, S.M.

doi:10.1016/j.clnesp.2014.12.002

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…SGA is a reliable clinical assessment method of nutritional status, based on the medical history and physical examination of the 130,677 subject providing a thorough estimation of nutritional status 29 . Previous studies showed that SGA scores were www.nature.com/scientificreports/ correlated with the presence and severity of DR status 30,31 . SGA scores are calculated after evaluating overall health status but include subjective factors to assess nutritional status.…”

Section: Discussionmentioning

confidence: 99%

Geriatric nutritional risk index is associated with retinopathy in patients with type 2 diabetes

Cho

Hong

Park

et al. 2022

Sci Rep

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The geriatric nutritional risk index (GNRI) is a nutrition-related risk assessment tool and has been used in various clinical settings. The relationship between body mass index (BMI) and the associated risk of diabetic retinopathy (DR) remains inconclusive. We aimed to evaluate the association between GNRI and DR in patients with type 2 diabetes. We included a total of 1359 patients with type 2 diabetes who followed up in our diabetes clinic and underwent fundus photographic examinations from August 2006 to February 2014. DR was assessed by retinal ophthalmologists using comprehensive ophthalmologic examinations. Patients were divided into tertiles according to their GNRI category. Patients in a lower GNRI tertile tended to have a higher proportion of nonproliferative DR (NPDR) and proliferative DR (PDR) compared with those in the other tertiles. The risk of PDR was higher in patients included in GNRI tertile 1 (Odds ratio (OR) 2.252, 95% Confidence Interval (CI) 1.080–4.823, P = 0.033) and GNRI tertile 2 (OR 2.602, 95% CI 1.323–5.336, P = 0.007) compared with those in GNRI tertile 3. In patients with lower GNRIs, the prevalence of DR was higher than in those with higher GNRIs. When GNRI was compared with BMI using the area under the curve, overall accuracy was high in GNRI. The risk of PDR was high in patients with low GNRI and there is an inverse association between GNRI scores and prevalence of DR. GNRI might be a useful tool to predict DR in patients with type 2 diabetes.

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“…which restrict the application of albumin in evaluating the nutrition status. Subjective Global Assessment (SGA) score was related to the presence and severity of DR, 30,31 whereas, this nutritional screening tool needs to be evaluated subjectively by the experienced examiners. PNI was obtained from objective markers including albumin and lymphocyte count, reflecting nutrition and immunity.…”

Section: Discussionmentioning

confidence: 99%

A Clinical Epidemiological Analysis of Prognostic Nutritional Index Associated with Diabetic Retinopathy

Yang¹,

Yu²,

Pan³

et al. 2021

DMSO

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Purpose Prognostic nutritional index (PNI) is an effective tool to evaluate the nutritional conditions and predict prognosis, but clinical data are limited for the use of PNI in diabetic retinopathy (DR). This study aimed to investigate the relationship of PNI with the prevalence and severity of DR in patients with type 2 diabetes mellitus (T2DM). Patients and Methods This cross-sectional analysis enrolled 1023 individuals with T2DM hospitalized between 2017–2020. PNI was calculated as 10 × serum albumin (g/l) + 0.005 × total lymphocyte count (cells/mL). DR severity was categorized as no, nonproliferative, and vision-threatened DR (VTDR) according to the modified Airlie House classification. Multivariate-adjusted odds ratio (OR) with 95% confidence interval (CI) for the prevalent DR in the top (Q4) compared with the bottom quartile (Q1) of PNI levels were estimated by using logistic regression analyses. Results PNI levels were significantly lower in individuals with VTDR than those with no and nonproliferative DR (both P < 0.001), and the proportions of individuals with DR were significantly decreased in the top quartile compared with the bottom quartile of PNI levels ( P < 0.001). After adjustments for age, gender, DM duration, obesity-related risk factors and clinical biochemical parameters, the higher levels of PNI were significantly associated with a lower prevalence of DR (Q4 vs Q1: OR = 0.402, 95% CI: 0.250–0.649, P < 0.001), with a 5.9% reduction in the prevalence of DR for a per-unit increment in the levels of PNI (OR = 0.941, 95% CI: 0.911–0.972, P < 0.001). The association of PNI and obesity-related indexes (body mass index and waist circumference) with the severity of DR was independent of each other (P<0.001). Conclusion PNI was inversely and independently associated with the severity and prevalence of DR, which suggested that PNI could likely be used to predict DR prognosis in clinical practice.

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“…The increased levels of AGEs have also been correlated with deranged metabolism thereby leading to compromised nutritional status. [ 26 ] Vitamin D deficiency has been found to be associated with disruption EZ. [ 27 ] Vitamin D also plays an important role in regulating calcium homeostasis.…”

Section: Discussionmentioning

confidence: 99%

Elevated advanced glycation end products are associated with subfoveal ellipsoid zone disruption in diabetic macular edema

Mishra

Singh²,

Singh³

et al. 2021

Indian J Ophthalmol

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Purpose: Advanced glycation end products (AGEs), due to increased production and a slow turnover rate, serve as mediators of “metabolic memory” even after the resolution of hyperglycemia. A prospective study was undertaken to evaluate the association of AGEs with subfoveal ellipsoid zone (EZ) disruption in diabetic macular edema (DME). Methods: A tertiary-care-center-based cross-sectional study included 40 consecutive cases with DME and 20 healthy controls in the age group of 40–65 years. All the study subjects underwent spectral-domain optical coherence tomography (SD-OCT) for cross-sectional imaging of the retina. The EZ was defined as a hyperreflective band below the external limiting membrane. The disruption of EZ was graded as intact EZ and disrupted EZ. Serum AGEs were assessed by assay of N ε -carboxymethyl-lysine ( N ε -CML) using the standard protocol. Data were analyzed statistically. Results: Subfoveal EZ disruption was noted in 80% (32/40) of the cases of DME. In the cases without EZ disruption, visual acuity (LogMAR VA) was 0.60 ± 0.52, whereas in cases with EZ disruption, LogMAR VA was 0.96 ± 0.56 ( P < 0.001). In the cases without EZ disruption, N ε -CML was 94.31 ± 57 ng/mL, whereas in cases with EZ disruption N ε -CML was 120.64 ± 71.98 ng/mL ( P < 0.001). Conclusion: In DME, increased levels of AGEs are significantly associated with EZ disruption on SD-OCT.

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Interrelationship of elevated serum Advanced Glycation End-product levels and malnutrition (Subjective Global Assessment) scores with the severity of retinopathy in type II diabetes

Cited by 5 publications

References 25 publications

Geriatric nutritional risk index is associated with retinopathy in patients with type 2 diabetes

A Clinical Epidemiological Analysis of Prognostic Nutritional Index Associated with Diabetic Retinopathy

Elevated advanced glycation end products are associated with subfoveal ellipsoid zone disruption in diabetic macular edema

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