# Ferrous ascorbate as a potential biomarker for diabetic retinopathy: a vitreous humour metabolomics study

## TL;DR

This study identifies ferrous ascorbate as a potential biomarker for diabetic retinopathy by analyzing vitreous humour metabolites and metabolic pathways.

## Contribution

The study introduces ferrous ascorbate as a novel potential biomarker for diabetic retinopathy.

## Key findings

- Twenty differential metabolites were identified, enriched in five key metabolic pathways linked to diabetic retinopathy.
- Ferrous ascorbate was found to contribute to poorer glycaemic control outcomes in diabetic retinopathy.
- Risk scores based on vitreous fluid metabolites can aid in the diagnosis and management of diabetic retinopathy.

## Abstract

This study aimed to explore differences in vitreous humour metabolites and metabolic pathways between patients with and without diabetic retinopathy (DR) and identify potential metabolite biomarkers.

Clinical data and vitreous fluid samples were collected from 125 patients (40 without diabetes, 85 with DR). The metabolite profiles of the vitreous fluid samples were analysed using ultra-high performance liquid chromatography, Q-Exactive mass spectrometry, and multivariate statistical analysis. A machine learning model based on Least Absolute Shrinkage and Selection Operator Regularized logistic regression was used to build a risk scoring model based on selected metabolite levels. Candidate metabolites were regressed to glycated haemoglobin levels by a logistic regression model.

Twenty differential metabolites were identified between the DR and control groups and were significantly enriched in five Kyoto Encyclopedia of Genes and Genomes pathways (arginine biosynthesis; tricarboxylic acid cycle; alanine, aspartate, and glutamate metabolism; tyrosine metabolism; and D-glutamate metabolism). Ferrous ascorbate significantly contributes to poorer glycaemic control outcomes, offering insights into potential new pathogenic pathways in DR.

Disorders in the metabolic pathways of arginine biosynthesis, tricarboxylic acid cycle, alanine, aspartate, glutamate metabolism, tyrosine metabolism, and D-glutamate metabolism were associated with DR. Risk scores based on vitreous fluid metabolites can be used for the diagnosis and management of DR. Ferrous ascorbate can provide insights into potential new pathogenic pathways for DR.

The online version contains supplementary material available at 10.1186/s12886-024-03530-6.