An association between the intestinal permeability biomarker zonulin and the development of diabetic retinopathy in type II diabetes mellitus

Author: Burak Erdem (Turkey)

Co-authors: Yasemin Kaya, Tugba Raika Kiran, Saadet Yilmaz

Purpose

Increased intestinal permeability (IP) and gut microbiota dysbiosis has been held responsible for low-grade chronic inflammation (LGCI). LGCI is an important underlying cause of diabetic retinopathy (DR) pathogenesis. This study aims to demonstrate the relationship between the IP biomarker zonulin and DR in patients with type 2 diabetes mellitus (T2DM).

Setting/Venue

Ordu University Training and Research Hospital

Methods

This study was conducted with a total of 89 T2DM patients including 33 non-DR, 28 non-proliferative DR (NPDR), 28 proliferative DR (PDR), and 32 healthy controls. Zonulin levels were determined with the ELISA kit by taking a blood sample.

Results

Zonulin levels were significantly higher in the PDR group compared to the other three groups (P=0.001). Also, it was significantly higher in the non-DR and NPDR groups compared to the control group. After multivariate logistic regression analysis, zonulin was found to be an independent predictor of DR (Odds Ratio: 1.781 95% Cl: 1.122-2.829 P= 0.014).

Conlusions

The current results in this study showed that participants with T2DM had high levels of serum zonulin. Moreover, serum zonulin levels are much higher in participants with PDR than in participants with NPDR and non-DR. Zonulin is an important indicator of IP and GMD. Accordingly, IP regulation and GM restructuring may be one of the main targets in DR treatment. More studies are needed to determine whether there is a direct association of a eubiotic GM and IP with DR.

Financial Disclosure

Financial Disclosure Authors have no financial or proprietary interest in any product mentioned in the article. Declaration of Interest No author has any possible conflict of interest. The authors alone are responsible for the content and preparation of the paper. Funding No funding was received for this research.