Vitreous advanced glycation endproducts and α-dicarbonyls in retinal detachment patients with type 2 diabetes mellitus and non-diabetic controls

PLoS One. 2017 Mar 6;12(3):e0173379. doi: 10.1371/journal.pone.0173379. eCollection 2017.


Purpose: Advanced glycation endproducts (AGEs) and their precursors α-dicarbonyls are implicated in the progression of diabetic retinopathy. The purpose of this study was to assess AGEs and α-dicarbonyls in the vitreous of patients with type 2 diabetes mellitus (T2DM) with early stages or absence of diabetic retinopathy.

Methods: We examined vitreous samples obtained during vitrectomy from 31 T2DM patients presenting themselves with rhegmatogenous retinal detachment and compared these to 62 non-diabetic rhegmatogenous retinal detachment patients, matched on age, estimated glomerular filtration rate, smoking, intra-ocular lens implantation, and proliferative vitreoretinopathy. AGEs (pentosidine, Nε-(carboxymethyl)lysine, Nε-(carboxyethyl)lysine, and 5-hydro-5-methylimidazolone) and α-dicarbonyls (3-deoxyglucosone, methylglyoxal, and glyoxal) were measured by ultra performance liquid chromatography or high performance liquid chromatography. Skin autofluorescence was measured by the AGE Reader.

Results: Mean age was 64 ± 7.6 years for T2DM patients and 63 ± 8.1 years for controls. For T2DM patients, median diabetes duration was 2.2 (0.3-7.4) years. Non-proliferative diabetic retinopathy was present in 1 patient and classified as absent or background retinopathy in 30 patients. Vitreous levels of pentosidine (2.20 vs. 1.59 μmol/mol lysine, p = 0.012) and 3-deoxyglucosone (809 vs. 615 nmol/L, p = 0.001) were significantly elevated in T2DM patients compared to controls. Other AGEs and α-dicarbonyls in the vitreous were not significantly different. There was a trend for increased skin autofluorescence in T2DM patients as compared to controls (p = 0.07).

Conclusions: Pentosidine and 3-deoxyglucosone concentrations were increased in the vitreous of rhegmatogenous retinal detachment patients with a relatively short duration of diabetes compared to non-diabetic rhegmatogenous retinal detachment patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arginine / analogs & derivatives
  • Arginine / metabolism
  • Biomarkers
  • Case-Control Studies
  • Deoxyglucose / analogs & derivatives
  • Deoxyglucose / metabolism
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Retinopathy / etiology*
  • Diabetic Retinopathy / metabolism*
  • Female
  • Glycation End Products, Advanced / metabolism*
  • Humans
  • Lysine / analogs & derivatives
  • Lysine / metabolism
  • Male
  • Middle Aged
  • Retinal Detachment / etiology*
  • Retinal Detachment / metabolism*


  • Biomarkers
  • Glycation End Products, Advanced
  • Arginine
  • Deoxyglucose
  • pentosidine
  • 3-deoxyglucosone
  • Lysine

Grant support

BTF was supported financially by Stichting Blindenhulp, The Netherlands ( This organization had no role in the design or conduct of this research.