Diyabetik Makula Ödemi Olan Bireylerde Serum İleri Glikasyon Son Ürünleri (AGEs) ile Beslenme Durumları Arasındaki İlişkinin Değerlendirilmesi

Abstract

Diabetic macular edema (DME) is a disease that can be seen at all stages of diabetic retinopathy, causing visual impairment and blindness. Uncontrolled (or poorly controlled) diabetes is more likely to cause retinopathy, and improving glycemic control with nutritional intake has been reported to be effective in preventing diabetic retinopathy. In patients with poor glycemic control, endogenous AGEs are produced. Also, dietary intake of exogenous AGE (dAGE) takes place along with nutrients. Therefore, this study was carried out with 90 type-2 diabetic individuals, 40 (14 male, 26 female) of whom were not diagnosed with DME and 50 (20 male, 30 female) individuals who were diagnosed with DME, followed up at the Department of Ophthalmology, Hacettepe University Faculty of Medicine to examine the relationship between serum AGEs, sRAGE and dAGE intake of individuals and DME disease. The individuals who underwent central foveal thickness (SFK) examination with optical coherence tomography (OCT) were administered a questionnaire to evaluate their sociodemographic characteristics, nutritional habits, dietary glycemic index, glycemic load and dietary total antioxidant capacity were calculated with food consumption records and food frequency questionnaire. Anthropometric measurements (waist, hips, height, weight, height) and physical activity records were taken. In serum samples from individuals, AGEs (carboxymethyl lysine (CML)), sRAGE levels were analyzed by ELISA method.The mean age of the DME group was 62.6 ± 8.4, and the mean age of the control group was 58.7 ± 7.8. AGEs levels of the DME group were found to be statistically significantly higher than the control group (p <0.05). According to the logistic regression analysis results of our study, one unit increase in AGEs levels increases the risk of DME 1.22 times (p <0.05). sRAGE levels were higher in the DME group, but there was no statistically significant difference between the groups (p> 0.05). Dietary intake of AGEs intake was statistically significantly higher in the DME group (p <0.05). It was found that one unit increase in dAGE intake increased the risk of DME by 1.24 times (p <0.05). While there was no significant relationship between diet glycemic index and dAGE in the case group (p> 0.05), a low moderately positive correlation was found between dietary glycemic load (GL) and dAGE (r = 0.333 p = 0.018).Increases in the neck circumference (OR: 1.24, CI: 1,08-1,41; p <0.001) and around the waist (OR: 1.06, p <0.05) were found to increase the risk of DME disease. High total antioxidant capacity of the diet has been found to reduce the risk of DME by 2.38 times (p <0.001). In this study, a positive correlation was found between DME and AGEs, dAGE, neck circumference, and waist circumference. In particular, limiting the intake of DAGE in individuals with diabetes may be effective in preventing the development of diabetes complications and DME. There was no significant relationship between sRAGE levels and DME. For the validity of these results, studies including controlled nutrition interventions are needed.