Advanced glycation end products are biomolecular biomarkers for proliferative diabetic retinopathy

The present study examines the role of advanced glycation end products (AGEs) as biomolecular biomarkers for proliferative diabetic retinopathy (PDR). A cross-sectional study with a total of 80 consecutive cases of type 2 diabetes mellitus (DM) was divided into no retinopathy (NoDR) ( n = 20), non-proliferative diabetic retinopathy (NPDR) ( n = 20), PDR ( n = 20), and controls ( n = 20). AGEs were assessed by assay of N-carboxymethyl-lysine (Nε-CML). Nε- CML was evaluated using receiver operating characteristic curve (ROC) curve analysis, and the area under curve (AUC) was determined. The mean levels of Nε-CML were 31.3 ± 21.2 ng/mL, 73.9 ± 35.0 ng/mL, 91.2 ± 66.7 ng/mL, and 132.0 ± 84.0 ng/mL in control, NoDR, NPDR, and PDR, respectively. On analysis of variance (ANOVA), the Ne-CML level was significantly different between the study groups (control, NoDR, NPDR, and PDR) ( P < 0.001). Best-corrected visual acuity decreased with disease progression and increased levels of Ne-CML ( P < 0.001). On AUC analysis, the following values were obtained NoDR = 0.67, NPDR = 0.69, and PDR = 0.84, showing that AGEs are the most sensitive biomarkers for PDR in DR. AGEs serve as biomolecular biomarkers for PDR and can indicate disease conversion from NPDR to PDR. They are new-age tools of translational medicine.