Research Division, Joslin Diabetes Center, Boston, MA, USA.
Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA.
Semin Ophthalmol. 2023 Jul;38(5):446-456. doi: 10.1080/08820538.2023.2168488. Epub 2023 Jan 29.
Clinical staging systems for diagnosis and treatment of diabetic retinopathy (DR) must closely relate to endpoints that are both relevant for patients and feasible for physicians to implement. Current DR staging systems for clinical eye care and research provide detailed phenotypic characterization to predict patient outcomes in diabetes but have limitations. Biochemical biomarkers provide a rich pool of potential candidates for new DR staging systems that can be readily measured in accessible fluids. Circulating biomarkers that are specific to the retina and relate to angiogenesis and inflammation have been suggested as relevant for DR. Although there is a lack of multi-ethnic studies evaluating circulatory biomarkers in DR, variability in circulatory biomarkers have been reported in people from different ethnic and racial backgrounds. Therefore, there is a need for future studies to evaluate individual or combinations of biomarkers in diverse populations with DR from different ethnic and racial backgrounds.
用于诊断和治疗糖尿病视网膜病变 (DR) 的临床分期系统必须与对患者相关且医生易于实施的终点密切相关。目前用于临床眼科护理和研究的 DR 分期系统提供了详细的表型特征描述,可预测糖尿病患者的预后,但存在局限性。生化标志物为新的 DR 分期系统提供了丰富的潜在候选物,这些标志物可在可及的体液中进行便捷测量。已经提出与血管生成和炎症相关的、针对视网膜的循环生物标志物作为与 DR 相关的标志物。尽管缺乏评估 DR 中循环生物标志物的多民族研究,但据报道,不同种族和不同背景的人群中的循环生物标志物存在差异。因此,需要未来的研究来评估来自不同种族和不同背景的 DR 患者中各种生物标志物或标志物组合的个体情况。