Individual and joint effects of trehalose and glutamate on diabetic retinopathy: a propensity score-matched case–control study

Abstract

Although previous studies demonstrate that trehalose can help maintain glucose homeostasis in healthy humans, its role and joint effect with gl utamate on diabetic retinopathy (DR) remain unclear. We aimed to comprehensively quantify the associations of trehalose and glutamate with DR. This study included 69 pair s of DR and matched type 2 diabetic (T2D) patients. Serum trehalose and glutamate were d etermined via ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry system. Covariates were collected by a standardized questionnai re, clinical examinations and laboratory assessments. Individual and joint association of trehalose and glutamate with DR were quantified by multiple conditional logistic regress ion models. The adjusted odds of DR averagely decreased by 86% (odds ratio (OR): 0.14; 9 5% CI: 0.06, 0.33) with per interquartile range increase of trehalose. Comparing with the l owest quartile, adjusted OR (95% CI) were 0.20 (0.05, 0.83), 0.14 (0.03, 0.63) and 0.01 (<0 .01, 0.05) for participants in the second, third and fourth quartiles of trehalose, respectively. In addition, as compared to their counterparts, T2D patients with lower trehalose (<medi an) and higher glutamate (≥median) had the highest odds of DR (OR: 36.81; 95% CI: 6.75, 20 0.61). An apparent super-multiplicative effect of trehalose and glutamate on DR was obser ved, whereas relative excess risk due to interaction was not significant. The study su ggests that trehalose is beneficial to inhibit the occurrence of DR and synergistically d ecreases the risk of DR with reduced glutamate. Our findings also provide new insights into t he mechanisms of DR and further longitudinal studies are required to confirm these findings.

Keywords

• diabetic retinopathy
• glutamate
• trehalose
• joint effect
• propensity score matching