Preventable risk factors for type 2 diabetes can be detected using noninvasive spontaneous electroretinogram signals

• DOI: 10.1371/journal.pone.0278388
• Publication Date: 2023-01-12T18:44:18Z
• Authors: Ramsés Noguez Imm; Julio Muñoz-Benitez; Diego Medina; Everardo Barcenas; Guillermo Molero-...; Pamela Reyes-Ortega; Jorge Armando Hug...; Leticia Medrano-G...; Manuel Miranda-Anaya; Gerardo Rojas-Piloni; Hugo Quiroz-Mercado; Luis Fernando Her...; Elisa Denisse Faj...; Ezequiel Ferreyra...; Renata García-Franco; Juan Fernando Rub...; Ellery López-Star; Marlon García-Roa; Van Charles Lansingh; Stéphanie C. Théb...
• Keywords: 0301 basic medicine; 2. Zero hunger; 0303 health sciences; Diabetic Retinopathy; Science; Q; R; 3. Good health; 03 medical and health sciences; Diabetes Mellitus, Type 2; Risk Factors; Electroretinography; Medicine; Humans; Obesity; Research Article

Given the ever-increasing prevalence of type 2 diabetes and obesity, the pressure on global healthcare is expected to be colossal, especially in terms of blindness. Electroretinogram (ERG) has long been perceived as a first-use technique for diagnosing eye diseases, and some studies suggested its use for preventable risk factors of type 2 diabetes and thereby diabetic retinopathy (DR). Here, we show that in a non-evoked mode, ERG signals contain spontaneous oscillations that predict disease cases in rodent models of obesity and in people with overweight, obesity, and metabolic syndrome but not yet diabetes, using one single random forest-based model. Classification performance was both internally and externally validated, and correlation analysis showed that the spontaneous oscillations of the non-evoked ERG are altered before oscillatory potentials, which are the current gold-standard for early DR. Principal component and discriminant analysis suggested that the slow frequency (0.4–0.7 Hz) components are the main discriminators for our predictive model. In addition, we established that the optimal conditions to record these informative signals, are 5-minute duration recordings under daylight conditions, using any ERG sensors, including ones working with portative, non-mydriatic devices. Our study provides an early warning system with promising applications for prevention, monitoring and even the development of new therapies against type 2 diabetes.