Predictive Value of the Advanced Lipoprotein Profile and Glycated Proteins on Diabetic Retinopathy

Abstract

This study aimed to assess whether the advanced characteristics of serum lipoprotein subclasses could better predict the risk of developing diabetic retinopathy (DR) and its severity compared to other established risk factors in subjects with type 1 (T1D) and type 2 (T2D) diabetes. This observational, cross-sectional substudy analyzed DR-related data from 309 T1D and 264 T2D subjects. The advanced lipoprotein and glycoprotein profile was determined by nuclear magnetic resonance (NMR) spectroscopy (Liposcale test). NMR analysis of lipoproteins revealed that T1D subjects with DR showed standard non-HDL particles, despite higher IDL lipid concentrations. Notably, IDL lipids were elevated in T1D subjects with worsened DR. VLDL and LDL were smaller, whereas HDL triglycerides were increased in DR compared with non-DR. On the other hand, the T2D subjects with DR showed altered characteristics in the LDL fraction, mainly revealed by a significant decrease in smaller LDL and a reduction in LDL-C. Moreover, the glycoprotein profile did not reveal significant changes among DR groups, regardless of the type of diabetes. However, lipoprotein characteristics and glycoproteins unveiled by NMR analysis did not improve the predictive value of conventional lipids or other traditional, well-established biomarkers of DR in our cohorts.

Association of Advanced Lipoprotein Subpopulation Profiles with Insulin Resistance and Inflammation in Patients with Type 2 Diabetes Mellitus

“…NMR generates unique spectra by simultaneously quantifying different lipoprotein subpopulations (sizes and concentrations) in single plasma run along with two emerging potential markers LPIR score and GlycA. Consistent with previous reports, our study showed that T2DM patients had a notable increase in number of large VLDL and small LDL particles as compared with reference values of healthy subjects ( Table 2 ) and other published data in healthy populations [ 22 , 31 , 58 , 60 ]. Additionally, T2DM patients had a notable decrease in the number of large HDL and LDL particles.…”

“…While there are some challenges and limitations for universal advanced lipoprotein profiling to be resolved, data generated in this study and from other groups consistently indicate that comprehensive NMR-derived lipoproteins analysis is a reliable and powerful tool that can expand diagnostic value and disease management when interpreting results of lipid panel and lipoproteins disturbance in T2DM patients. Most of published studies on advanced assessment of lipoproteins species by NMR technique have been focusing on the prediction of T2DM in apparently healthy populations [ 4 , 22 , 55 , 56 , 57 , 58 , 59 ]. In this study we provide a comprehensive examination of the effects of insulin resistance on NMR-determined lipoprotein subpopulation profiles in T2DM patients.…”

“…In the past decades, several analytical assays have been developed to separate plasma lipoproteins based on particles composition, number, and size [ 15 , 16 , 17 , 18 ]. With the development of new assays using nuclear magnetic resonance (NMR) spectroscopy, several studies focused on the relationship between lipoprotein subfractions and cardiovascular outcomes [ 19 , 20 , 21 , 22 ].…”