Serum Elabela Levels are Negatively Associated with Retinopathy in Type 2 Diabetic Patients

Aims Abnormal expression of Elabela (ELA) is associated with various diseases, including diabetic nephropathy. However, the roles of ELA on developing diabetic retinopathy (DR) are not known. The aim of this study is to confirm the relationship between serum Elabela (ELA) levels and DR in patients with type 2 diabetes mellitus (T2DM). Methods A total of 90 healthy donors (Control group ) and 270 patients with T2DM were recruited. The were divided into three groups: Normal T2DM without DR, T2DM with nonproliferlative DR and T2DM with proliferative DR, 90 patients including in each group. Basic general clinical characteristics were collected and serum ELA levels were determined using the ELISA kit. Results The results showed that there was no significant difference in serum ELA levels between normal control and T2DM patients, but it significantly decreased in nonproliferlative DR and proliferative DR patients compared with T2DM without DR. Compared with nonproliferlative DR patients, the serum ELA levels further significantly decreased in proliferative DR patients. ELA has a significantly negative correlation with DR, duration of diabetes, age, systolic blood pressure(SBP), Blood urea nitrogen(BUN), serum creatinine(Cre) and urinary albumin/creatinine ratio (ACR), and is positively correlated with body mass index (BMI) and estimated glomerular filtration rate (eGFR). Furthermore, the univariate and multivariate linear regression analysis showed that DR, duration of diabetes and BMI were the risk factors for ELA after adjusting for relevant confounding factors (P < 0.05).According to the ROC curve analysis, ELA could identify subjects with DR with a sensitivity of 54.4% and a specificity of 73.3%. Conclusions With the deterioration of DR, the level of serum ELA decreases gradually. ELA may be involved in the occurrence and development of DR, and ELA may be a potential clinical predictor and therapeutic target of DR.