Department of Ophthalmology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, People's Republic of China.
Suzhou Center for Disease Control and Prevention, 72 Sanxiang Road, Suzhou, 215004, People's Republic of China.
Acta Diabetol. 2021 Feb;58(2):221-229. doi: 10.1007/s00592-020-01610-9. Epub 2020 Oct 16.
To determine the relationship between plasma levels of trimethylamine-N-oxide (TMAO) and odds of diabetic retinopathy (DR).
A cross-sectional study was conducted. Blood samples were obtained from 122 type 2 diabetes mellitus (T2DM) patients with or without DR. Multivariable logistic regression analyses were performed to identify the association between plasma TMAO and DR. The diagnostic value of plasma TMAO was assessed by the area under the receiver operating characteristic curve (AUROC) and integrated discrimination improvement (IDI).
In the T2DM patients, plasma levels of TMAO were significantly higher in patients with DR compared with those without DR (P = 0.001). As logarithmic (ln) transformation of TMAO increased per standard deviation (SD), there was higher probability to have DR [odds ratio (OR) = 2.31; P = 0.005]. As ln-transformed TMAO increased per SD, the severity of DR was more likely to get worse (OR = 2.05; P = 0.004). In the diagnostic model, the addition of TMAO contributed to the improvement in AUROC from 0.646 to 0.734 (P = 0.043), and the IDI was 10.7% (P < 0.001).
Elevated levels of plasma TMAO were associated with higher odds and worse severity of DR in T2DM patients, and further investigation is required for the causality of this association.
确定血浆中三甲胺 N-氧化物（TMAO）水平与糖尿病视网膜病变（DR）发生几率之间的关系。
进行了一项横断面研究。从 122 名 2 型糖尿病（T2DM）患者中采集血液样本，这些患者患有或不患有 DR。采用多变量逻辑回归分析来确定血浆 TMAO 与 DR 之间的关联。通过接受者操作特征曲线（AUROC）下面积和综合判别改善（IDI）评估血浆 TMAO 的诊断价值。
在 T2DM 患者中，患有 DR 的患者的血浆 TMAO 水平明显高于没有 DR 的患者（P=0.001）。当 TMAO 对数（ln）转换值每增加一个标准差（SD）时，发生 DR 的可能性就会更高[比值比（OR）=2.31；P=0.005]。当 ln 转换的 TMAO 每增加一个 SD 时，DR 的严重程度更有可能恶化（OR=2.05；P=0.004）。在诊断模型中，添加 TMAO 可使 AUROC 从 0.646 提高到 0.734（P=0.043），IDI 为 10.7%（P<0.001）。
血浆 TMAO 水平升高与 T2DM 患者发生 DR 的几率和严重程度增加有关，需要进一步研究这种关联的因果关系。
