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. 2024 Jan 8:14:1299206.
doi: 10.3389/fendo.2023.1299206. eCollection 2023.

Correlation of mild cognitive impairment with the thickness of retinal nerve fiber layer and serum indicators in type 2 diabetic patients

Renshi Li #  1 , Fengjie Zheng #  2 , Peichen Xu  2 , Li Lv  2 , Yapeng Mu  2 , Xianghua Zhuang  2 , Shihong Chen  2
Affiliations

Correlation of mild cognitive impairment with the thickness of retinal nerve fiber layer and serum indicators in type 2 diabetic patients

Renshi Li et al. Front Endocrinol (Lausanne). .

Erratum in

Abstract

Background: Cognitive Impairment arising from type 2 diabetes mellitus (T2DM) has garnered significant attention in recent times. However, there are few studies on the identification and diagnosis of markers of cognitive impairment. Notably, alterations in the Retinal Nerve Fiber Layer's (RNFL) thickness can potentially serve as an indicative measure of central nervous system changes. Further investigations have indicated that the decline in cognitive function within T2DM patients is intricately linked to persistent systemic inflammation and the accumulation of advanced glycosylation end products. Comprehensive studies are warranted to unveil these complex associations.

Objective: This study aims to explore the potential of utilizing the RNFL thickness and serological concentrations of IL-18, irisin, CML, and RAGE as diagnostic indicators for Mild Cognitive Impairment (MCI) among individuals with T2DM.

Methods: The thickness of RNFL were determined in all patients and controls using optical coherence tomography (OCT). The serum levels of IL-18, irisin, CML and RAGE were detected by ELISA kit. In addition, Cognitive assessment was performed by the Mini-Mental State Examination (MMSE) and the Montreal Cognitive assessment (MoCA).

Results: The average RNFL thickness in the right eye were decreased in T2DM and T2DM combined with MCI (T2DM-MCI) patients and were positively correlated with MoCA and MMSE scores. The serum levels of IL-18, CML and RAGE in T2DM and T2DM-MCI increased significantly (p<0.05) and were negative correlated with MoCA and MMSE scores. The level of irisin in T2DM and T2DM-MCI decreased significantly (p<0.05) and were positively correlated with MoCA and MMSE scores. The area under the ROC curve of T2DM-MCI predicted by the average RNFL thickness in the right eye, CML and RAGE were 0.853, 0.874 and 0.815. The diagnostic efficacy of the combination of average RNFL thickness in the right eye, CML, and RAGE for the diagnosis of T2DM-MCI was 0.969.

Conclusion: The average RNFL thickness in the right eye, CML and RAGE have possible diagnostic value in T2DM-MCI patients.

Keywords: carboxymethyl lysine; interleukin-18; irisin; mild cognitive impairment; receptors for AGEs; the thickness of retinal nerve fiber layer; type 2 diabetes mellitus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
RNFL thickness in different groups. The scatter plots accompanied by the mean ± SD present the RNFL thickness in control, T2DM and T2DM-MCI groups. *p<0.05.
Figure 2
Figure 2
ROC curves for mean RNFL in the right eye, CML, RAGE, and MCI. G (right eye): AUC 0.853, sensitivity 91.7%, specificity 61.0%. CML: AUC 0.874, sensitivity: 82.9%, specificity: 90.2%. RAGE: AUC 0.815, Sensitivity 68.6%, Specificity 82.9%.
Figure 3
Figure 3
ROC curves for mean RNFL thickness, CML, and RAGE diagnosis in the right eye. G (right eye) + CML: AUC 0.948, sensitivity 88.6%, specificity 87.8%. G(right eye)+RAGE:AUC 0.939, sensitivity 82.9%, specificity 87.8%. G(right eye)+CML+RAGE: AUC 0.969, sensitivity 88.6%, specificity 95.1%.
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