The obesity paradox: Retinopathy, obesity, and circulating risk markers in youth with type 2 diabetes in the TODAY Study
Year: 2022
Type: article
Abstract: AIM: To understand the relationship of obesity and 27 circulating inflammatory biomarkers to the prevalence of non-proliferative diabetic retinopathy (NPDR) in youth with type 2 diabetes. METHODS: Youth with type 2 diabetes who participated in the TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) study were followed for 2-6.5 years. Digital fundus photographs were obtained in the last year of the study. Blood samples during the study were processed for inflammatory biomarkers, and these were correlated with obesity tertiles and presence of retinopathy. RESULTS: Higher BMI was associated with an increase in circulating levels of metabolic biomarkers including high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor 1 (PAI-1), fibrinogen, LDL-cholesterol (LDL-C) and Apolipoprotein B (ApoB), tumor necrosis factor receptors 1 and 2 (TNFR-1 and -2), interleukin 6 (IL-6), E-selectin, and homocysteine, as well as a decrease in the metabolic risk markers HDL-cholesterol (HDLC), and insulin-like growth factor binding protein 1 (IGFBP-1). Although NPDR risk decreased with increasing obesity, it was not associated with any of the measured biomarkers. CONCLUSIONS: Circulating levels of measured biomarkers did not elucidate the "obesity paradox" of decreased NPDR in the most obese participants in the TODAY study. TRIAL REGISTRATION: clinicaltrials.govNCT00081328.
Institutions: Massachusetts General Hospital, George Washington University, Baylor College of Medicine, Rainbow Babies & Children's Hospital, Case Western Reserve University, Children's Hospital of Philadelphia, University of Wisconsin–Madison, Yale University, University of Oklahoma Health Sciences Center, SUNY Upstate Medical University
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,100
Funders: Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, GlaxoSmithKline, Sanofi, Massachusetts General Hospital, Yale University, Children's Hospital of Philadelphia, Children's Hospital Los Angeles, Washington University in St. Louis, University of Oklahoma, Case Western Reserve University, BD, National Institutes of Health, University of Oklahoma Health Sciences Center, University of Colorado Denver, NIH Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, NIH Clinical Center, National Center for Advancing Translational Sciences, Children's Hospital of Pittsburgh
Awards: G1013201491, G1044130170, G1092612401, G1106622594, G1205751828, G1250539109, G1264432290, G1320905697, G1354339833, G1388832763, G1415392549, G1415733790, G1415791185, G1444064448, Management of Pediatric Type 2 Diabetes Mellitus, G149689038, G1541337408, G1585053098, G158963794, G1598118648, G163357278, G1650331929, G1686083716, G1694266950, G1711233980, G1740463284, G1789861183, G1824217007, G1846855846, G1908270963, G1922015097, G20328578, G2032961523, G203683428, G2062090893, G2078309758, G2106774427, G2116505794, G2150299440, G2191010568, G2191150108, G2215945170, G2216600238, G2222857569, G2236591371, G2244966566, G2250838539, G2290786691, G2316854700, G2356874604, G2411441375, G2417121299, G2445381393, G246532802, G2523152196, G2527449299, G2540315505, G2633030757, G2717308754, G27536180, G278975345, G2824222223, G2825566498, G2835588625, G284260254, G2866075081, G2871802236, G2939982320, G299222429, G3029844320, G3065435095, G3089208431, G3247330982, G3258243794, G3314594697, G3394423889, G3489756685, G3499161329, G3505391940, G3523087171, G3568430941, G3639507971, G3655660282, G3683390921, G3709130456, G3770193043, G3814294633, G383008977, G3832661877, G3905150972, G400592931, G4012495729, G4069642107, G4113217758, Type 2 Diabetes in Youth: Beta Cell Preservation, G4136598395, G426894015, G4338432551, G4412256101, G4412971278, G4455723224, G4549954026, G4748915099, G4856566612, G4948594166, G5013342786, G5021569069, G5176381802, G523627176, G5265485444, G5308902211, G5318790011, G547031277, G5495349041, G5539551523, G554783770, G5562050619, G5599334769, G5634851252, G5640239032, G5649216467, G5682572468, G5819948109, G5830866086, G5833800221, G5886479391, General Clinical Research Center, G6028481119, G606898507, General Clinical Research Center, G6251626332, G629490077, G6304731611, G6308904801, G6322753410, G6447481305, G658110454, G6749227604, G6771701953, G6826710578, G6879181497, G6980401035, G7016995429, G7043484107, G7114955226, G7239803534, G733747580, G7361550427, G7382394668, G7399781317, G742032275, G7423062132, G7432973588, G7435963951, G7503690254, G756633534, G7573920588, G7614789687, G7635370081, G7670230208, G7771770858, G7785802778, G7786997528, G800374514, G8060904442, G8084777885, G8110711965, G8118477788, G8149264117, G8202566466, Colorado Clinical and Transational Sciences Institute, G8260572741, G834258283, G8377578562, G8587357073, G8715459185, Clinical and Translational Science Collaborative of Cleveland, G8796660116, G881343144, G8864794000, G8871414559, G889535532, G8900235588, G9000000078, G9000016200, G9000032576, G9000037442, G9000042762, G9000068737, G9000071235, G9000081471, G9000085504, G9000086393, G9000109397, G9000110373, G9000199034, G9000238543, G9000259551, G9000266062, G9000349463, University of Pittsburgh Clinical and Translational Science Institute, Yale Clinical and Translational Science Award, G903953877
OpenAlex ID: W4286251176