Am J Ophthalmol: Plasma arginine and citrulline increased in patients with type 2 diabetic retinopathy

Diabetic retinopathy (DR) is a progressive complication of diabetes and the main cause of blindness worldwide
.

The global prevalence of adult DR in 2015 was estimated at 415 million, and it is expected to rise to 642 million by 2042

Diabetic retinopathy (DR) is a progressive complication of diabetes and the main cause of blindness worldwide

DR progressed from a lighter non-proliferative phase (NPDR) to a more severe proliferative phase (PDR)

Figure 1: Figure 1: Simplified description of the arginase and nitric oxide synthase pathways

OAT = ornithine aminotransferase, AL = arginine succinate lyase, AS = arginine succinate synthase, ADMA = asymmetric dimethylarginine

The purpose of this study is to identify 6 arginine and citrulline related metabolites (arginine, citrulline, asymmetric dimethylarginine [ADMA], ornithine, proline, and arginine Succinate) differs between patients with type 2 diabetic retinopathy (DR) and type 2 diabetes controls, or between patients with proliferative DR (PDR) and non-proliferative DR (NPDR)
.

The purpose of
this study is to identify 6 arginine and citrulline related metabolites (arginine, citrulline, asymmetric dimethylarginine [ADMA], ornithine, proline, and arginine Succinate) differs between patients with type 2 diabetic retinopathy (DR) and type 2 diabetes controls, or between patients with proliferative DR (PDR) and non-proliferative DR (NPDR) .

The purpose is to identify 6 arginine and citrulline related metabolites (arginine, citrulline, asymmetric dimethylarginine [ADMA], ornithine, proline, and arginine succinate Salt) There are differences between patients with type 2 diabetic retinopathy (DR) and type 2 diabetes controls, or between proliferative DR (PDR) and non-proliferative DR (NPDR)

Design design design

Cross-sectional study
.

Recruiting adult patients with type 2 diabetes from the Vanderbilt Eye Institute

Cross-sectional study

Result result result

Figure 2 : Unadjusted analysis showed that compared with the diabetic control group, plasma arginine, citrulline, ADMA, ornithine and arginine succinate levels were significantly increased in DR patients, but there was no difference in proline levels
.

Figure 2 : Unadjusted analysis showed that compared with the diabetic control group, plasma arginine, citrulline, ADMA, ornithine and arginine succinate levels were significantly increased in DR patients, but there was no difference in proline levels
.

Figure 2 : Unadjusted analysis showed that compared with the diabetic control group, plasma arginine, citrulline, ADMA, ornithine and arginine succinate levels were significantly increased in DR patients, but there was no difference in proline levels

Table 2 : In order to explain the potential confounding effects of demographic or clinical differences between groups, we performed a multivariate logistic regression analysis for each metabolite with retinopathy as the outcome, adjusted for age, gender, HbA1c, diabetes course, and statins The use of drug-like drugs or ACEI/ARB (Table 2)
.

In these regressions, DR patients had significantly higher levels of arginine (P = 0.

Table 2 : In order to explain the potential confounding effects of demographic or clinical differences between groups, we performed a multivariate logistic regression analysis for each metabolite with retinopathy as the outcome, adjusted for age, gender, HbA1c, diabetes course, and statins The use of drug-like drugs or ACEI/ARB (Table 2)

Table 3 : We repeated logistic regression analysis for the subgroups of patients who added creatinine as a covariate (Table 3), and found that after adjusting for multiple tests, compared with the diabetic control group, the arginine of DR patients (FDR adjusted P = 0.
0067) and citrulline (FDR corrected P = 0.
0025) levels were still significantly increased
.

Table 3 : We repeated logistic regression analysis for the subgroups of patients who added creatinine as a covariate (Table 3), and found that after adjusting for multiple tests, compared with the diabetic control group, the arginine of DR patients (FDR adjusted P = 0.
0067) and citrulline (FDR corrected P = 0.
0025) levels were still significantly increased
.

Table 3 Table 3We repeated logistic regression analysis for the subgroups of patients who added creatinine as a covariate (Table 3), and found that after adjusting for multiple tests, compared with the diabetic control group, the arginine of DR patients (FDR adjusted P = 0.
0067) and citrulline (FDR corrected P = 0.
0025) levels were still significantly increased
.

Figure 3 : In an unadjusted analysis, PDR patients (n=64) have higher plasma ADMA than NPDR patients (n=92)

Figure 3 : In the unadjusted analysis, plasma ADMA of PDR patients (n=64) was higher than that of NPDR patients (n=92) Figure 3 : In the unadjusted analysis, plasma ADMA of PDR patients (n=64) was higher than NPDR Patient (n=92)Figure 3

Table 4 : Multivariate logistic regression analysis controlling age, gender, HbA1c, diabetes course, statin use and ACEI/ARB use (Table 4) also showed that compared with NPDR patients, PDR patients had ADMA (P = 0.
0051) Significant increase, including after adjustment for multiple testing (FDR adjusted P = 0.
031)
.

Table 4 : Multivariate logistic regression analysis controlling age, gender, HbA1c, diabetes course, statin use and ACEI/ARB use (Table 4) also showed that compared with NPDR patients, PDR patients had ADMA (P = 0.
0051) Significant increase, including after adjustment for multiple testing (FDR adjusted P = 0.
031)
.
Table 4 : Multivariate logistic regression analysis controlling age, gender, HbA1c, diabetes course, statin use and ACEI/ARB use (Table 4) also showed that compared with NPDR patients, PDR patients had ADMA (P = 0.
0051) Significant increase, including after adjustment for multiple testing (FDR adjusted P = 0.
031)
.
Table 4

As mentioned in the supplementary material, in order to explain the renal function in NPDR and PDR analysis, a logistic regression analysis was performed on a subset of DR patients with available creatinine data (n = 58 NPDR, n = 42 PDR)
.
In the smaller cohort where creatinine was added to the model, there was no longer a significant difference in ADMA between NPDR and PDR patients (OR = 1.
30, 95% CI = 0.
90-1.
91, P = 0.
15)
.
For comparison, logistic regression was also performed in a smaller cohort without creatinine as a covariate
.
A logistic regression analysis in a smaller cohort without creatinine showed a marginal difference in ADMA values ​​between NPDR and PDR patients (P = 0.
051)
.

As mentioned in the supplementary material, in order to explain the renal function in NPDR and PDR analysis, a logistic regression analysis was performed on a subset of DR patients with available creatinine data (n = 58 NPDR, n = 42 PDR)
.
In the smaller cohort where creatinine was added to the model, there was no longer a significant difference in ADMA between NPDR and PDR patients (OR = 1.
30, 95% CI = 0.
90-1.
91, P = 0.
15)
.
For comparison, logistic regression was also performed in a smaller cohort without creatinine as a covariate
.
A logistic regression analysis in a smaller cohort without creatinine showed a marginal difference in ADMA values ​​between NPDR and PDR patients (P = 0.
051)
.
As mentioned in the supplementary material, in order to explain the renal function in NPDR and PDR analysis, a logistic regression analysis was performed on a subset of DR patients with available creatinine data (n = 58 NPDR, n = 42 PDR)
.
In the smaller cohort where creatinine was added to the model, there was no longer a significant difference in ADMA between NPDR and PDR patients (OR = 1.
30, 95% CI = 0.
90-1.
91, P = 0.
15)
.
For comparison, logistic regression was also performed in a smaller cohort without creatinine as a covariate
.
A logistic regression analysis in a smaller cohort without creatinine showed a marginal difference in ADMA values ​​between NPDR and PDR patients (P = 0.
051)
.
As mentioned in the supplementary material, in order to explain the renal function in NPDR and PDR analysis, a logistic regression analysis was performed on a subset of DR patients with available creatinine data (n = 58 NPDR, n = 42 PDR)
.
In the smaller cohort where creatinine was added to the model, there was no longer a significant difference in ADMA between NPDR and PDR patients (OR = 1.
30, 95% CI = 0.
90-1.
91, P = 0.
15)
.
In the smaller cohort with creatinine added to the model, there was no significant difference in ADMA between NPDR and PDR patients.
For comparison, logistic regression was also performed in the smaller cohort without creatinine as a covariate
.
A logistic regression analysis in a smaller cohort without creatinine showed a marginal difference in ADMA values ​​between NPDR and PDR patients (P = 0.
051)
.

in conclusion

Conclusion Conclusion Conclusion

This study showed that compared with the diabetic control group, the plasma arginine and citrulline of patients with type 2 diabetes with retinopathy increased
.
We also found that compared with NPDR patients, plasma ADMA in PDR patients was elevated, although this relationship was not significant in the subgroup of patients with creatinine values
.
This study confirms the importance of arginine and citrulline metabolism in DR, and emphasizes the need for future research on how these metabolites cause this debilitating disease
.

This study showed that compared with the diabetic control group, the plasma arginine and citrulline of patients with type 2 diabetes with retinopathy increased
.
We also found that compared with NPDR patients, plasma ADMA in PDR patients was elevated, although this relationship was not significant in the subgroup of patients with creatinine values
.
This study showed that compared with the diabetic control group, the plasma arginine and citrulline of patients with type 2 diabetes with retinopathy increased
.
We also found that compared with NPDR patients, plasma ADMA in PDR patients was elevated, although this relationship was not significant in the subgroup of patients with creatinine values
.
This study showed that compared with the diabetic control group, the plasma arginine and citrulline of patients with type 2 diabetes with retinopathy increased
.
We also found that compared with NPDR patients, plasma ADMA in PDR patients was elevated, although this relationship was not significant in the subgroup of patients with creatinine values
.
This study confirms the importance of arginine and citrulline metabolism in DR, and emphasizes the need for future research on how these metabolites cause this debilitating disease
.
This study confirms the importance of arginine and citrulline metabolism in DR, and emphasizes the need for future research on how these metabolites cause this debilitating disease
.
This study confirms the importance of arginine and citrulline metabolism in DR, and emphasizes the need for future studies on how these metabolites cause this debilitating disease.
This study confirms the importance of arginine and citrulline.
The importance of amino acid metabolism in DR and emphasizes the need for future research on how these metabolites cause this debilitating disease

 

Original link: https://pubmed.
ncbi.
nlm.
nih.
gov/34587493/

Original link: https://pubmed.
ncbi.
nlm.
nih.
gov/34587493/ https://pubmed.
ncbi.
nlm.
nih.
gov/34587493/

Plasma Arginine and Citrulline are Elevated in Diabetic Retinopathy

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