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Journal article
Lipidomic profiles and their relationship to incident diabetic retinopathy in type 2 diabetes: The Fremantle Diabetes Study Phase II
Journal of diabetes and its complications, Vol.40(11), 109412
2026
PMID: 42748732
Abstract
To determine whether plasma lipid profiles predict diabetic retinopathy (DR).
DR status (none, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR/worse) was categorised in 762 adults with type 2 diabetes (mean age 64.5 years, 54.3% males) at baseline and Year 4/6. Ultra-performance liquid chromatography-tandem mass spectrometry generated baseline plasma lipid profiles. Multiple logistic regression identified baseline associates of new/worsening DR and incident DR. The likelihood ratio test (LRT) evaluated incremental biomarker contribution. The net reclassification improvement (NRI) was calculated.
New/worsening DR occurred in 121 (16%). Of 495 without DR at baseline, 35 (7.0%) developed DR. For new/worsening DR, the inclusion of cholesterol ester (20:4), fatty acid (20:3) and lysophosphatidylglycerol (18:1) in addition to conventional risk factors (hypertension, HbA1c, diabetes treatment intensity, urinary albumin:creatinine) added to the conventional model predictivity (LRT, P = 0.00002). The NRI gain at a 10% cut-off was 5.7% (SE 2.8%; P = 0.043). For incident DR, fatty acid (20:3), lysophosphatidylglycerol (18:0) and phosphatidylcholine (18:0_20:3) with HbA1c improved model performance (LRT, P = 0.00001). The NRI gain at 5% risk cut-off for incident DR was 28.3% (P = 0.002).
This exploratory study identified five lipid biomarkers with the potential to improve DR risk prediction and the understanding of pathophysiological mechanisms.
•Lipidomic biomarkers could enhance prediction of incident diabetic retinopathy (DR).•Baseline plasma lipid profiles were generated in people living with type 2 diabetes.•New/worsening DR and incident DR were assessed over 4 years of follow-up.•Five lipid moieties added to conventional variables in predicting these outcomes.•Lipid biomarkers may improve DR risk prediction and provide mechanistic insights.
Details
- Title
- Lipidomic profiles and their relationship to incident diabetic retinopathy in type 2 diabetes: The Fremantle Diabetes Study Phase II
- Authors/Creators
- Timothy M.E. Davis - The University of Western AustraliaJocelyn J. Drinkwater - Lions Eye InstituteAlanah Grant-St James - Murdoch UniversityElaine Holmes - Murdoch UniversityWendy A. Davis - The University of Western AustraliaNicola Gray - Murdoch University
- Publication Details
- Journal of diabetes and its complications, Vol.40(11), 109412
- Publisher
- Elsevier Inc; NEW YORK
- Number of pages
- 8
- Identifiers
- 991005919750207891
- Copyright
- © 2026 The Authors.
- Murdoch Affiliation
- School of Medical, Molecular and Forensic Sciences; Centre for Computational and Systems Medicine
- Language
- English
- Resource Type
- Journal article
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