乙醇胺可作为血糖控制良好的糖尿病患者发生糖尿病视网膜病变的潜在生物标志物和基于生物标志物的防治策略

作     者：胡光奕 顾丽萍 王若男 菅启智 吕康甲 夏梦雪 赖梦宇 申婷婷 胡敬 杨森 叶存奇 张筱楠 王育璠 许迅 张芳 Guangyi Hu;Liping Gu;Ruonan Wang;Qizhi Jian;Kangjia Lv;Mengxue Xia;Mengyu Lai;Tingting Shen;Jing Hu;Sen Yang;Cunqi Ye;Xiaonan Zhang;Yufan Wang;Xun Xu;Fang Zhang

作者机构：National Clinical Research Center for Eye DiseasesDepartment of OphthalmologyShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200080China Department of Endocrinology and MetabolismShanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200080China Eye Institute of Shanghai Jiao Tong University SchoolShanghai 200080China Shanghai Key Laboratory of Fundus DiseasesShanghai 200080China Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye DiseasesShanghai 200080China Zhejiang Provincial Key Laboratory for Cancer Molecular Cell BiologyLife Sciences InstituteZhejiang UniversityHangzhou 310058China Kidney Disease CenterThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China 

出 版 物：《Science Bulletin》 (科学通报（英文版）)

年 卷 期：2024年第69卷第12期

页      面：1920-1935页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100212[医学-眼科学] 10[医学] 

基　　金：supported by the Key R&D project of the National Ministry of Science and Technology(2023YFA1801100) the Major Research Plan of the National Natural Science Foundation of China(92357307 and 92057106) the National Natural Science Foundation of China(32171177 and 81870610) Shanghai Jiaotong University-Gaofeng Clinical Medicine Grant 

主　　题：Glucose-well-controlled diabetic patients Diabetic retinopathy Biomarker HbA1c Ethanolamine Biomarker-based treatment 

摘      要：Diabetic retinopathy(DR)is the leading cause of blindness among the working-age *** controlling blood glucose levels effectively reduces the incidence and development of DR to less than 50%,there are currently no diagnostic biomarkers or effective treatments for DR development in glucose-wellcontrolled diabetic patients(GW-DR).In this study,we established a prospective GW-DR cohort by strictly adhering to glycemic control guidelines and maintaining regular retinal examinations over a median 2-year follow-up *** discovery cohort encompassed 71 individuals selected from a pool of 292 recruited diabetic patients at baseline,all of whom consistently maintained hemoglobin A1c(HbA1c)levels below 7%without experiencing *** this cohort of 71 individuals,21 subsequently experienced new-onset GW-DR,resulting in an incidence rate of 29.6%.In the validation cohort,we also observed a significant GW-DR incidence rate of 17.9%.Employing targeted metabolomics,we investigated the metabolic characteristics of serum in GW-DR,revealing a significant association between lower levels of ethanolamine and GW-DR *** association was corroborated in the validation cohort,exhibiting superior diagnostic performance in distinguishing GW-DR from diabetes compared to the conventional risk factor HbA1c,with AUCs of 0.954 versus 0.506 and 0.906 versus 0.521 in the discovery and validation cohorts,***,in a streptozotocin(STZ)-induced diabetic rat model,ethanolamine attenuated diabetic retinal inflammation,accompanied by suppression of microglial diacylglycerol(DAG)-dependent protein kinase C(PKC)pathway *** conclusion,we propose that ethanolamine is a potential biomarker and represents a viable biomarker-based therapeutic option for GW-DR.