AUTHOR=Zhang Xinyuan , Nie Yao , Gong Zhizhong , Zhu Meidong , Qiu Bingjie , Wang Qiyun 

TITLE=Plasma Apolipoproteins Predicting the Occurrence and Severity of Diabetic Retinopathy in Patients With Type 2 Diabetes Mellitus

JOURNAL=Frontiers in Endocrinology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.915575

DOI=10.3389/fendo.2022.915575

ISSN=1664-2392

ABSTRACT=<sec><title>Objective</title><p>Apolipoproteins are amphipathic molecules and the major components of plasma lipoproteins. This study aims to investigate the effects of dysregulated apolipoprotein (apo) profiles and their ratios on type 2 diabetes mellitus (T2DM) and diabetic retinopathy (DR) further to test the hypothesis that altered serum level of apolipoproteins is strong biomarkers for DR.</p></sec><sec><title>Research Design and Methods</title><p>This case-control study consists of 157 patients with T2DM including DM without DR, non-proliferative DR (NPDR), and proliferative DR (PDR). Fifty-eight age- and sex-matched healthy subjects were enrolled as normal controls. Blood biochemistry profile including serum levels of glucose, glycated hemoglobin (HbA1c), lipid profile [total cholesterol (TC), Triglycerides (TG), high and low-density lipoprotein (HDL-C and LDL-C)] was estimated. Apolipoproteins (apos, A-I, A-II, B, C-II, C-III, and E) was evaluated by protein chips (Luminex technology). Apolipoprotein ratios and arteriosclerosis-associated plasma indices were calculated. The Kruskal–Wallis test, independent sample t-test or Mann–Whitney U test, and multivariate regression analysis were performed to investigate the association of serum lipid biomarkers and the DR severity.</p></sec><sec><title>Results</title><p>Serum level of apoA-I was negatively correlated with TC-(HDL-C)/HDL-C (<italic>p</italic> &lt; 0.001), fasting glucose (<italic>p</italic> &lt; 0.001), HbA1c (<italic>p</italic> &lt; 0.001), and (<italic>p</italic>&lt;0.001), while apoE, apoC-II/apoC-III, apoA-II/apoA-I were positively correlated with above traditional biomarkers (<italic>p</italic> &lt; 0.001). Single variable logistic analysis results showed that body mass index (BMI) (<italic>p</italic> = 0.023), DM duration (<italic>p</italic> &lt; 0.001), apoE (<italic>p</italic> &lt; 0.001), apoC-II/apo C-III (<italic>p</italic> &lt; 0.001), apoE/apoC-II (<italic>p</italic> &lt; 0.001), atherogenic index (<italic>p</italic> = 0.013), fasting glucose (<italic>p</italic> &lt; 0.001), HbA1c (<italic>p</italic> &lt; 0.001), LPA (<italic>p</italic> = 0.001), and LDL-C/HDL-C (<italic>p</italic> = 0.031) were risk factors for the occurrence and severity of DR. Multivariate logistic regression mode showed that apoC-II/apoC-III and apoB/non–HDL-C (<italic>p</italic> &lt; 0.001) as well as apoE/apoC-II (<italic>p</italic> = 0.001) were the independent risk factors for the occurrence and severity of DR—apopA-I and apoA-II are protective factors for DR—after controlling for the duration of DM, HbA1c, fasting glucose, and LPA.</p></sec><sec><title>Conclusions</title><p>apoE, apoC-II/apoC-III, apoE/apoC-II, and apoB/non–HDL-C could be used as novel biomarkers for occurrence and severity of DR, whereas apoA-I and apoA-II resulted as protective factors for DR.</p></sec>