Evaluation of sphingolipid metabolism on diabetic retinopathy

Purpose: To evaluate the aqueous and serum levels of sphingolipid metabolism mediators such as sphingosine 1 phosphate (S1P), sphingosine kinase 1 (SK1), sphingosine kinase 2 (SK2), ceramide kinase (CK), and acid sphingomyelinase (ASM) which are thought to take part in diabetic retinopathy (DR) pathogenesis, and development and severity of diabetic retinopathy (DR) in patients with type 2 diabetes. Methods: A prospective cross-sectional study was conducted on type 2 diabetic and control patients who underwent cataract surgery. Three different subgroups, namely, non-diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR), were allocated and the S1P, SK1, SK2, CK, and ASM levels in the serum and aqueous humor samples of diabetic and control patients were evaluated. Kolmogorov-Smirnov test, Student's t-test, and Mann-Whitney U test were used for the statistical analysis of the study. Results: Among a total of 45 patients, including diabetic and control patients, the mean aqueous levels of SK1 (P < 0.001), SK2 (P = 0.012), ASM (P = 0.006), and CK (P = 0.002) were higher in all diabetic patients. The mean aqueous level of S1P was significantly higher in the PDR group than in other groups (P = 0.003). The mean aqueous levels of SK2 and ASM also increased in the NDR, NPDR, and PDR subgroups, respectively (P < 0.001). In addition, the mean serum levels of S1P, SK1, and ASM were higher in the diabetic patients (P = 0.015, P = 0.034, and P = 0.006, respectively). Conclusion: According to our findings, both aqueous and serum levels of S1P, SK1, and ASM and only the aqueous levels of SK2 and CK were higher in diabetic patients. This study suggested that sphingolipid metabolism may play an important role in DR pathogenesis.