Aldosari Dalia I, Malik Ajamaluddin, Alhomida Abdullah S, Ola Mohammad S
Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia.
Front Neurosci. 2022 Jul 13;16:938029. doi: 10.3389/fnins.2022.938029. eCollection 2022.
Diabetic retinopathy (DR) is one of the major complications of diabetic eye diseases, causing vision loss and blindness worldwide. The concept of diabetic retinopathy has evolved from microvascular disease into more complex neurovascular disorders. Early in the disease progression of diabetes, the neuronal and glial cells are compromised before any microvascular abnormalities clinically detected by the ophthalmoscopic examination. This implies understanding the pathophysiological mechanisms at the early stage of disease progression especially due to diabetes-induced metabolic alterations to damage the neural retina so that early intervention and treatments options can be identified to prevent and inhibit the progression of DR. Hyperglycemia has been widely considered the major contributor to the progression of the retinal damage, even though tight control of glucose does not seem to have a bigger effect on the incidence or progression of retinal damage that leads to DR. Emerging evidence suggests that besides diabetes-induced hyperglycemia, dyslipidemia and amino acid defects might be a major contributor to the progression of early neurovascular retinal damage. In this review, we have discussed recent advances in the alterations of key metabolites of carbohydrate, lipid, and amino acids and their implications for neurovascular damage in DR.
糖尿病视网膜病变（DR）是糖尿病眼部疾病的主要并发症之一，在全球范围内导致视力丧失和失明。糖尿病视网膜病变的概念已从微血管疾病演变为更复杂的神经血管疾病。在糖尿病疾病进展的早期，在通过眼底镜检查临床检测到任何微血管异常之前，神经元和神经胶质细胞就已受损。这意味着要了解疾病进展早期的病理生理机制，特别是由于糖尿病引起的代谢改变对神经视网膜的损害，以便能够确定早期干预措施和治疗方案，以预防和抑制DR的进展。高血糖一直被广泛认为是视网膜损伤进展的主要因素，尽管严格控制血糖似乎对导致DR的视网膜损伤的发生率或进展没有更大影响。新出现的证据表明，除了糖尿病引起的高血糖外，血脂异常和氨基酸缺陷可能是早期神经血管性视网膜损伤进展的主要因素。在这篇综述中，我们讨论了碳水化合物、脂质和氨基酸关键代谢物变化的最新进展及其对DR中神经血管损伤的影响。
