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Updated: Jan 13, 2026

Characterization of a Novel Human Organotypic Retinal Culture Technique
Published on: June 9, 2021
Serum Albumin and Glycemic Variability Could Contribute to Diabetic Retinopathy Progression by Regulating Chronic
Jack Jonathan Maran1, Charisse Y-J Kuo1, Ilva D Rupenthal1
1Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand, auckland.ac.nz.
Purpose:
Despite managing glycemic levels and other risk factors, individuals with type 2 diabetes (T2DM) may still experience diabetic retinopathy (DR) progression. This study investigated clinical predictors of DR progression in T2DM patients following bariatric surgery.
Methods:
This study was a retrospective post hoc analysis of participants from a clinical randomized controlled trial of bariatric surgery patients with T2DM (ACTRN12611000751976) who had complete DR screening and blood data at baseline and 5 years post-bariatric surgery. Plasma cytokine concentrations were also examined.
Results:
DR progression was strongly associated with a postoperative decrease in serum albumin (OR = 0.461, 95% CI: 0.221-0.962, p = 0.039). This decrease also predicted postoperative increases in IL-6 (OR = infinity, sensitivity = 100.00%, p = 0.0162) and IL-1β (OR = 11.250, sensitivity = 81.82%, p = 0.0154), known to be linked to NLRP3 inflammasome activation. In addition, individuals who progressed in DR severity showed greater month-to-month HbA1c variability compared to stable individuals (mean difference: 0.6583%, 95% CI: 0.1821-1.134%, p = 0.0115).
Conclusions:
Decreases in serum albumin and increased glycemic variability may influence DR progression through the NLRP3 inflammasome and inflammatory pathways. Further research is needed to clarify the role and mechanism of albumin loss in DR progression.
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