Exploring metabolomic clues in diabetic retinopathy: a pilot study

with diabetes 1.Prevalence is expected to increase; by 2045, an estimated 160.50 million adults worldwide will be afflicted by DR, and 44.82 million will experience visionthreatening DR 1.Early detection is necessary for reducing DR progression.Despite major risk factors such as hyperglycemia, hypertension, and dyslipidemia, considerable variability in DR onset and progression remains unexplained.This suggests a need to explore pathophysiological mechanisms and biomarker identification.Emerging evidence from metabolomics-the study of small-molecule metabolites in biological systems-has shown promise in uncovering molecular alterations associated with diabetic complications, including DR 2.Previous studies identified metabolites like 12-hydroxyeicosatetraenoic acid (12-HETE) and 3,4-dihydroxybutyrate (3,4-DHBA) as DR-related 2, pointing to inflammation and altered lipid metabolism.However, few studies include healthy controls (HC) in addition to DR and no-DR groups 2.Recognizing the need for more comprehensive designs, this study uses untargeted metabolomics to examine DR, no-DR, and HC groups to identify biomarkers and gain insight into DR pathogenesis. Materials and methodsWe analyzed baseline fasting serum samples from 77 participants aged 40-65 years, drawn from a cohort who had previously enrolled in sleep and circadian rhythm studies conducted at a tertiary academic hospital.Post-illumination pupillary light reflex (PIPR), a measure of intrinsically photosensitive retinal ganglion cells (ipRGCs) located in the inner retina, and nocturnal urinary 6-sulfatoxymelatonin (aMT6s); both previously shown to be reduced in DR, were collected using standardized protocols, previously