Diabetic retinopathy is a condition that affects blood vessels in the eye’s retina. If left untreated, it can result in vision loss. This layer of tissue found near the optic nerve is the retina — it receives light through the lens, allowing visual recognition within the brain. Diabetic retinopathy damages blood vessels, leading to the eventual loss of vision.
In its early stages, diabetic retinopathy often lacks outward symptoms. At most, early symptoms may come and go, causing mild issues with vision, which can be easily overlooked. Yet, early detection is vital in providing the best possible outcome to patients.
Over time, diabetic retinopathy can lead to diabetic macular edema (DME), neovascular glaucoma, and retinal detachment.
New Research Makes a Tie to Klotho Levels
An anti-aging hormone called Klotho has been found to be capable of predicting the progression of both cardiovascular and retinal disease. New research has shown that reduced levels of circulating Klotho can increase the risk of diabetic retinopathy progression by as much as 44%. Functioning as a vascular protective hormone, Klotho shows great potential to act as a biomarker, and even a treatment target, for diabetic retinopathy.
A Potential New Therapeutic Target
Klotho shows great promise in indicating an increased risk of new outset diabetic retinopathy and the progression of the disease. Klotho therapy may be a key tool in preventing and treating diabetic retinopathy, allowing for intervention that may prevent the development of vision loss.
How Studies Uncovered this New Target
A recent study, published in the Journal of Diabetes and Vascular Disease Research, selected 81 individuals with type 2 diabetes. At the baseline of approximately 44 months, the study’s participants were checked for circulating levels of Klotho, as well as other markers. These samples were stored and measured.
At the start of the observational period, researchers found a baseline median circulating serum Klotho level of 265 pg/ml. At baseline, 58% of participants showed some existing evidence of diabetic retinopathy.
Monoscopic fundus photos of dilated pupils, each taken with a non-mydriatic camera, were used to watch for signs of progressing or early-onset diabetic retinopathy. Further, serum Klotho levels—as well as levels of phosphorus, calcium, vitamin D, and fibroblast growth factor-23—were measured using the previously stored samples.
Less Circulating Klotho Relates to Diabetic Retinopathy
Lower levels of circulating serum Klotho were found in the patients who showed progression of diabetic retinopathy compared to participants who did not. Of the participants with progressed retinopathy, just over half (24 patients) were cases of new-onset retinopathy, while just under half (22 patients) were cases of further progression of existing retinopathy.
After performing multivariable logistic regression analyses, it was revealed that baseline Klotho level was the sole variable to be independently linked to a reduced risk of retinopathy progression. Final results suggest that by halving a patient’s levels of circulating Klotho, there is a 44% higher risk of the progression of retinopathy. (Further, this effect was independent of traditional risk factors for the advancement of diabetic retinopathy, including systolic and diastolic blood pressure measures and the duration of the patient’s diabetes.)
Future Implications
Klotho therapy shows immense promise. Research has shown that there seems to be a significant correlation between the onset or progression of diabetic retinopathy and circulating serum Klotho. In the future, Klotho could be a primary target for prevention and treatment.
