Correlation between the levels of serum TSG-14, ALBP and EGLN1 and the severity of diabetic macularmajor edema
Serum TSG-14, ALBP and EGLN1 and the severity of diabetic macularmajor edema
Abstract
Objective To investigate the relationships among serum TNF-stimulated gene 14 (TSG-14), Adipocyte Lipid Binding Protein (ALBP), and Egl Nine Homolog 1(EGLN1) levels and the severity of diabetic macular edema (DME).
Methods A total of 314 patients with DME who were admitted to our hospital from March 2022 to March 2025 were selected (DME group). The patients were divided into mild, moderate and severe groups according to their severity. Additionally, 314 patients with simple T2DM who were admitted to our hospital during the same period were selected (T2DM group). The levels of serum TSG-14, ALBP and EGLN1 were detected via ELISA. Logistic analysis was employed to ascertain the determinants of severe DME, and receiver operating characteristic (ROC) curves were constructed to evaluate the blood levels of TSG-14, ALBP, and EGLN1 in patients with severe DME.
Results There were significant differences in the duration of diabetes, fasting blood glucose, glycosylated hemoglobin, and homocysteine levels between the T2DM group and the DME group (all P < 0.05). Compared with those in the T2DM group, the levels of serum TSG-14, ALBP, and EGLN1 in the DME group were considerably larger (all P < 0.05). Serum TSG-14, ALBP, and EGLN1 levels in the moderate and severe groups were significantly higher (all P < 0.05) than those in the mild group; serum TSG-14, ALBP, and EGLN1 levels in the severe group were significantly higher (all P < 0.05) than those in the moderate group. According to logistic analysis, EGLN1, ALBP, and TSG-14 were risk factors for severe DME (all P < 0.05). When evaluating patients with severe DME, the ROC curve results showed that the AUCs of serum TSG-14, ALBP, and EGLN1 alone and in combination were 0.781, 0.805, 0.817, and 0.950, respectively. The combined evaluation's AUC was higher than the individual evaluation's (Z = 2.699, 2.714, and 2.717, all P < 0.05).
Conclusion The levels of TSG-14, ALBP and EGLN1 in the serum of DME patients were dramatically raised. These three signs are related to the severity of the condition. The combination detection approach has certain clinical utility for evaluating patients with severe DME.
References
2.Watkins C, Paulo T, Bührer C, Holekamp NM, Bagijn M. Comparative Efficacy, Durability and Safety of Faricimab in the Treatment of Diabetic Macular Edema: A Systematic Literature Review and Network Meta-Analysis. Adv Ther. 2023 Dec;40(12):5204-5221. doi: 10.1007/s12325-023-02675-y. Epub 2023 Sep 26. Erratum in: Adv Ther. 2024 May;41(5):2084-2085. doi: 10.1007/s12325-024-02831-y. PMID: 37751021; PMCID: PMC10937806.
3.Pesonen M, Jylhä V, Kankaanpää E. Adverse drug events in cost-effectiveness models of pharmacological interventions for diabetes, diabetic retinopathy, and diabetic macular edema: a scoping review. JBI Evid Synth. 2024 Nov 1;22(11):2194-2266. doi: 10.11124/JBIES-23-00511. PMID: 39054883; PMCID: PMC11554252.
4.Zarbin M, Tabano D, Ahmed A, Amador M, Ding A, Holekamp N, Lu XY, Stoilov I, Yang M. Efficacy of Faricimab versus Aflibercept in Diabetic Macular Edema in the 20/50 or Worse Vision Subgroup in Phase III YOSEMITE and RHINE Trials. Ophthalmology. 2024 Nov;131(11):1258-1270. doi: 10.1016/j.ophtha.2024.05.025. Epub 2024 Jun 8. PMID: 38852921.
5.Crespo-Garcia S, Fournier F, Diaz-Marin R, Klier S, Ragusa D, Masaki L, Cagnone G, Blot G, Hafiane I, Dejda A, Rizk R, Juneau R, Buscarlet M, Chorfi S, Patel P, Beltran PJ, Joyal JS, Rezende FA, Hata M, Nguyen A, Sullivan L, Damiano J, Wilson AM, Mallette FA, David NE, Ghosh A, Tsuruda PR, Dananberg J, Sapieha P. Therapeutic targeting of cellular senescence in diabetic macular edema: preclinical and phase 1 trial results. Nat Med. 2024 Feb;30(2):443-454. doi: 10.1038/s41591-024-02802-4. Epub 2024 Feb 6. PMID: 38321220.
6.Wykoff CC, Garweg JG, Regillo C, Souied E, Wolf S, Dhoot DS, Agostini HT, Chang A, Laude A, Wachtlin J, Kovacic L, Wang L, Wang Y, Bouillaud E, Brown DM. KESTREL and KITE Phase 3 Studies: 100-Week Results With Brolucizumab in Patients With Diabetic Macular Edema. Am J Ophthalmol. 2024 Apr;260:70-83. doi: 10.1016/j.ajo.2023.07.012. Epub 2023 Jul 15. PMID: 37460036.
7.Ou SH, Chang WC, Wu LY, Wang SI, Wei JC, Lee PT. Diabetic Macular Edema Is Predictive of Renal Failure in Patients With Diabetes Mellitus and Chronic Kidney Disease. J Clin Endocrinol Metab. 2024 Feb 20;109(3):761-770. doi: 10.1210/clinem/dgad581. PMID: 37804118.
8.Eleftheriadou A, Riley D, Zhao SS, Austin P, Hernández G, Lip GYH, Jackson TL, Wilding JPH, Alam U. Risk of diabetic retinopathy and diabetic macular edema with sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in type 2 diabetes: a real-world data study from a global federated database. Diabetologia. 2024 Jul;67(7):1271-1282. doi: 10.1007/s00125-024-06132-5. Epub 2024 Apr 8. PMID: 38584180; PMCID: PMC11153282.
9.Muayad J, Loya A, Hussain ZS, Lee DH, Chauhan MZ, Lee AG, Movahedan A, Dahr SS. Influence of Common Medications on Diabetic Macular Edema in Type 2 Diabetes Mellitus. Ophthalmol Retina. 2025 Jun;9(6):505-514. doi: 10.1016/j.oret.2024.12.006. Epub 2024 Dec 5. PMID: 39644923.
10.Sutton SS, Magagnoli J, Cummings TH, Hardin JW, Ambati J. Allopurinol and the Risk of Diabetic Macular Edema among U.S. Veterans with Type 2 Diabetes. Ocul Immunol Inflamm. 2024 Aug;32(6):969-975. doi: 10.1080/09273948.2023.2170886. Epub 2023 Feb 7. PMID: 36749950; PMCID: PMC10404628.
11.Szeto SK, Lai TY, Vujosevic S, Sun JK, Sadda SR, Tan G, Sivaprasad S, Wong TY, Cheung CY. Optical coherence tomography in the management of diabetic macular edema. Prog Retin Eye Res. 2024 Jan;98:101220. doi: 10.1016/j.preteyeres.2023.101220. Epub 2023 Nov 7. Erratum in: Prog Retin Eye Res. 2025 Jan;104:101319. doi: 10.1016/j.preteyeres.2024.101319. PMID: 37944588.
12.Virgili G, Curran K, Lucenteforte E, Peto T, Parravano M. Anti-vascular endothelial growth factor for diabetic macular edema: a network meta-analysis. Cochrane Database Syst Rev. 2023 Jun 27;2023(6):CD007419. doi: 10.1002/14651858.CD007419.pub7. PMID: 38275741; PMCID: PMC10294542.
13.Wu G, Hu Y, Zhu Q, Liang A, Du Z, Zheng C, Liang Y, Zheng Y, Hu Y, Kong L, Liang Y, Amadou MLDJ, Fang Y, Liu Y, Feng S, Yuan L, Cao D, Lin J, Yu H. Development and validation of a simple and practical model for early detection of diabetic macular edema in patients with type 2 diabetes mellitus using easily accessible systemic variables. J Transl Med. 2024 May 31;22(1):523. doi: 10.1186/s12967-024-05328-y. PMID: 38822359; PMCID: PMC11140894.
14.Brown DM, Boyer DS, Do DV, Wykoff CC, Sakamoto T, Win P, Joshi S, Salehi-Had H, Seres A, Berliner AJ, Leal S, Vitti R, Chu KW, Reed K, Rao R, Cheng Y, Sun W, Voronca D, Bhore R, Schmidt-Ott U, Schmelter T, Schulze A, Zhang X, Hirshberg B, Yancopoulos GD, Sivaprasad S; PHOTON Investigators. Intravitreal aflibercept 8 mg in diabetic macular edema (PHOTON): 48-week results from a randomized, double-masked, noninferiority, phase 2/3 trial. Lancet. 2024 Mar 23;403(10432):1153-1163. doi: 10.1016/S0140-6736(23)02577-1. Epub 2024 Mar 7. PMID: 38461843.
15.Do LK, Kuo CY, Misra SL, Murphy R, Mugisho OO. Linking HbA1c and white blood cell counts to the development of diabetic macular edema in type 2 diabetes: A systematic review and meta-analysis. J Diabetes Complications. 2026 Feb;40(2):109237. doi: 10.1016/j.jdiacomp.2025.109237. Epub 2025 Dec 1. PMID: 41389390.
16.Kumar G, Velu S, Rajalakshmi R, Surya J, Mohan V, Raman A, Raman R. Compliance with follow-up in patients with diabetic macular edema: Eye care center vs. diabetes care center. Indian J Ophthalmol. 2023 Jun;71(6):2531-2536. doi: 10.4103/IJO.IJO_220_23. PMID: 37322675; PMCID: PMC10417951.
17.Chan LKY, Lin SS, Chan F, Ng DS. Optimizing treatment for diabetic macular edema during cataract surgery. Front Endocrinol (Lausanne). 2023 Jan 25;14:1106706. doi: 10.3389/fendo.2023.1106706. PMID: 36761187; PMCID: PMC9905225.
18.Tsui CK, Hu A, Li Y, Huang W, Wang W, Liu K, Xie L, Li Y, Congdon N, Liang X; GDES Group. Prevalence, incidence, and risk factors for diabetic retinopathy and macular edema in patients with early and late-onset type 2 diabetes mellitus. J Diabetes Investig. 2025 Jul;16(7):1254-1262. doi: 10.1111/jdi.70027. Epub 2025 Apr 10. PMID: 40211545; PMCID: PMC12209516.
19.Sutton SS, Magagnoli J, Cummings TH, Hardin JW, Ambati J. Author Reply to Letter to the Editor: In Response to: Comment on Sutton et al.'s "Allopurinol and the Risk of Diabetic Macular Edema among U.S. Veterans with Type 2 Diabetes". Ocul Immunol Inflamm. 2024 Sep;32(7):1454-1456. doi: 10.1080/09273948.2023.2219326. Epub 2023 Jun 15. PMID: 37318233; PMCID: PMC10721714.
20.Lai SW. Comment on Sutton et al.'s "Allopurinol and the Risk of Diabetic Macular Edema Among U.S. Veterans with Type 2 Diabetes". Ocul Immunol Inflamm. 2024 Sep;32(7):1509. doi: 10.1080/09273948.2023.2209169. Epub 2023 May 5. PMID: 37145497.
21.Lazăr AS, Stanca HT, Tăbăcaru B, Danielescu C, Munteanu M, Stanca S. Quantitative Parameters Relevant for Diabetic Macular Edema Evaluation by Optical Coherence Tomography Angiography. Medicina (Kaunas). 2023 Jun 10;59(6):1120. doi: 10.3390/medicina59061120. PMID: 37374324; PMCID: PMC10300947.
22.Nakao S, Kusuhara S, Murakami T. Anti-VEGF therapy for the long-term management of diabetic macular edema: a treat-to-target strategy based on macular morphology. Graefes Arch Clin Exp Ophthalmol. 2024 Dec;262(12):3749-3759. doi: 10.1007/s00417-024-06558-y. Epub 2024 Jul 12. PMID: 38995350; PMCID: PMC11608304.
23.Yamamoto M, Fujihara K, Hasebe H, Yaguchi Y, Yamada T, Kodama S, Tanaka S, Sone H. Positive association of large alcohol intake per occasion with vision-threatening severe diabetic retinopathy or diabetic macular edema in Japanese men with type 2 diabetes. Prev Med. 2025 Feb;191:108220. doi: 10.1016/j.ypmed.2025.108220. Epub 2025 Jan 4. PMID: 39761921.
24.Tai F, Nanji K, Garg A, Zeraatkar D, Phillips M, Steel DH, Garg SJ, Kaiser PK, Guymer RH, Wykoff CC, Sivaprasad S, Chaudhary V. Subthreshold Compared with Threshold Macular Photocoagulation for Diabetic Macular Edema: A Systematic Review and Meta-Analysis. Ophthalmol Retina. 2024 Mar;8(3):223-233. doi: 10.1016/j.oret.2023.09.022. Epub 2023 Oct 5. PMID: 37805099.
25.Gu Q, Pan T, Cheng R, Huang J, Zhang K, Zhang J, Yang Y, Cheng P, Liu Q, Shen H. Macular vascular and photoreceptor changes for diabetic macular edema at early stage. Sci Rep. 2024 Sep 4;14(1):20544. doi: 10.1038/s41598-024-71286-6. PMID: 39232012; PMCID: PMC11374796.
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