Serum essential trace elements and toxic metals in Chinese diabetic retinopathy patients

Abstract

Trace elements are essential for the proper functioning of proteins, enzymes, and transcriptional factors. However, toxic metals will compete with essential trace elements, and damage enzymatic activities and various physiological functions. We aimed to investigate the status of serum essential trace elements and toxic metals in Chinese diabetic retinopathy (DR) patients, and to analyze their associations. This retrospective study included 33 normal subjects (normal group), 44 type 2 diabetes mellitus (T2D) patients with DR (DR group), and 58 T2D patients without DR (diabetes mellitus [DM] group). Serum levels of zinc (Zn), manganese (Mn), cadmium (Cd), and cesium (Cs), were measured for all participants using inductively coupled plasma-mass spectrometry. The serum concentrations of Mn (0.0226 μg/L) and Zn (98.162 μg/L) were significantly lower in DR group, compared with both the DM group and normal group (P < 0.05). In contrast, the serum levels of Cs (0.0354 μg/L) and Cd (0.0149 μg/L) were significantly higher in DR group, compared with the normal group (Cs: z = 3.136, P = .002; Cd: z = 3.766, P < .0001). Similarly, the serum Cs level in the DM group was 0.0323 μg/L, which was significantly higher than that in the normal group (0.0167 μg/L, z = 2.692, P = .007). Moreover, the area under the receiver-operating characteristic curve values of Mn (0.753 [95% confidence interval, CI 0.635–0.872, P = .002]), and Cd (0.797 [95% CI 0.643–0.952, P = .003]) were significantly greater than those of Zn and Cs, for DR identification. Our results suggest that deficient essential trace elements and accumulated toxic metals were highly associated with the presence of DR.

Association between serum heavy metal levels and diabetic retinopathy in NHANES 2011–2020

“…Handan et al found that Se exerts a protective effect on retinal pigment epithelium (ARPE-19) and primary human retinal microvascular endothelial (ACBRI 181) cells against high glucose (HG)-induced oxidative stress and apoptosis 21 . A previous retrospective study found that blood Cd levels were higher in the DR group than in the DM group 22 . These findings are inconsistent with our results, perhaps due to different populations, races, disease states, and health conditions that affect the absorption, transport, and metabolism of Se and Cd in the body, affecting the association between Se and Cd and the disease.…”

Comparison of selenium levels between diabetic patients with and without retinopathy

“…One study from China that included 135 patients investigated the role of serum trace elements and heavy metal levels in diabetic retinopathy [23]. The study found that the serum concentrations of manganese (Mn) and zinc (Zn) were significantly lower in the diabetic retinopathy group, while cadmium (Cd) and cesium (Cs) levels were higher [23]. However, only selenium levels were measured in the study and not other trace elements.…”

Blood Cadmium Affects the Association between Serum 25-Hydroxyvitamin D₃ and Diabetic Retinopathy Severity in the U.S. Population with Type 2 Diabetes

“…It is a source of mitochondrial reactive oxygen species (ROS) in DR, and it can disrupt glucose uptake and regulation (12,29). Some previous studies indicated that accumulated cadmium was highly associated with the presence of DR (13,28,29).…”

“…It is a source of mitochondrial reactive oxygen species (ROS) in DR, and it can disrupt pancreatic b cells (12). One previous study had shown that the serum levels of cadmium was significantly higher in the DR groups (13). Another study was suggested that high cadmium levels decrease the formation of calcitriol (active vitamin D) in blood, thereby decreasing calcium absorption (14).…”