Department of Ophthalmology, King George's Medical University, Lucknow, Uttar Pradesh, India.
CSIR-Indian Institute of Toxicological Research, Lucknow and Department of Biochemistry, State Medical College Bahraich, Uttar Pradesh, India.
Indian J Ophthalmol. 2021 Nov;69(11):3199-3202. doi: 10.4103/ijo.IJO_1244_21.
Advanced glycation end products (AGEs), due to increased production and a slow turnover rate, serve as mediators of "metabolic memory" even after the resolution of hyperglycemia. A prospective study was undertaken to evaluate the association of AGEs with subfoveal ellipsoid zone (EZ) disruption in diabetic macular edema (DME).
A tertiary-care-center-based cross-sectional study included 40 consecutive cases with DME and 20 healthy controls in the age group of 40-65 years. All the study subjects underwent spectral-domain optical coherence tomography (SD-OCT) for cross-sectional imaging of the retina. The EZ was defined as a hyperreflective band below the external limiting membrane. The disruption of EZ was graded as intact EZ and disrupted EZ. Serum AGEs were assessed by assay of N-carboxymethyl-lysine (N-CML) using the standard protocol. Data were analyzed statistically.
Subfoveal EZ disruption was noted in 80% (32/40) of the cases of DME. In the cases without EZ disruption, visual acuity (LogMAR VA) was 0.60 ± 0.52, whereas in cases with EZ disruption, LogMAR VA was 0.96 ± 0.56 (P < 0.001). In the cases without EZ disruption, N-CML was 94.31 ± 57 ng/mL, whereas in cases with EZ disruption N-CML was 120.64 ± 71.98 ng/mL (P < 0.001).
In DME, increased levels of AGEs are significantly associated with EZ disruption on SD-OCT.
由于产生增加和周转率缓慢，晚期糖基化终产物 (AGEs) 即使在高血糖得到解决后，也可作为“代谢记忆”的介质。进行了一项前瞻性研究，以评估 AGEs 与糖尿病性黄斑水肿 (DME) 中中心凹下椭圆体带 (EZ) 破坏的相关性。
一项基于三级保健中心的横断面研究纳入了 40 例连续的 DME 病例和 20 名年龄在 40-65 岁之间的健康对照者。所有研究对象均接受频域光学相干断层扫描 (SD-OCT) 进行视网膜的横断面成像。EZ 定义为外节膜下的高反射带。EZ 破坏程度分为完整 EZ 和破坏 EZ。通过使用标准方案测定 N-羧甲基赖氨酸 (N-CML) 来评估血清 AGEs。对数据进行统计学分析。
在 40 例 DME 病例中，80%（32/40）存在中心凹下 EZ 破坏。在 EZ 未破坏的病例中，视力（LogMAR VA）为 0.60 ± 0.52，而在 EZ 破坏的病例中，LogMAR VA 为 0.96 ± 0.56（P < 0.001）。在 EZ 未破坏的病例中，N-CML 为 94.31 ± 57 ng/mL，而在 EZ 破坏的病例中，N-CML 为 120.64 ± 71.98 ng/mL（P < 0.001）。
在 DME 中，AGEs 水平升高与 SD-OCT 上的 EZ 破坏明显相关。
