title: Enhanced Oxidative Stress and Other Potential Biomarkers for Retinopathy in Type 2 Diabetics: Beneficial Effects of the Nutraceutic Supplements.
abstract: We have studied the global risk of retinopathy in a Mediterranean population of type 2 diabetes mellitus (T2DM) patients, according to clinical, biochemical, and lifestyle biomarkers. The effects of the oral supplementation containing antioxidants/omega 3 fatty acids (A/ω3) were also evaluated. Suitable participants were distributed into two main groups: (1) T2DMG (with retinopathy (+DR) or without retinopathy (-DR)) and (2) controls (CG). Participants were randomly assigned (+A/ω3) or not (-A/ω3) to the oral supplementation with a daily pill of Nutrof Omega (R) for 18 months. Data collected including demographics, anthropometrics, characteristics/lifestyle, ophthalmic examination (best corrected visual acuity, ocular fundus photographs, and retinal thickness as assessed by optical coherence tomography), and blood parameters (glucose, glycosylated hemoglobin, triglycerides, malondialdehyde, and total antioxidant capacity) were registered, integrated, and statistically processed by the SPSS 15.0 program. Finally, 208 participants (130 diabetics (68 +DR/62 -DR) and 78 controls) completed the follow-up. Blood analyses confirmed that the T2DMG+DR patients had significantly higher oxidative stress (p < 0.05), inflammatory (p < 0.05), and vascular (p < 0.001) risk markers than the T2DMG-DR and the CG. Furthermore, the A/ω3 oral supplementation positively changed the baseline parameters, presumptively by inducing metabolic activation and ameliorating the ocular health after 18 months of supplementation.
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Roig-Revert
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lleó-Pérez
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Zanón-Moreno
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain.
authors.forename: Bárbara
authors.initials: B
authors.lastname: Vivar-Llopis
authors.affiliation: Ophthalmology Department, University Hospital "Arnau de Vilanova", 12 San Clemente Street, 46015 Valencia, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Marín-Montiel
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain ; Ophthalmology Department, University and Polytechnic Hospital "La Fe", 106 Fernando Abril Martorell Avenida, 46026 Valencia, Spain ; Spanish Net of Ophthalmic Pathology OFTARED, Institute of Health Carlos III, 4 Sinesio Delgado Street, 28029 Madrid, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Dolz-Marco
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Clinic and Research Department, Clinica Oftalmológica Rahhal, 52 Cirilo Amorós Street, 46004 Valencia, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Alonso-Muñoz
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Department, Hospital Vinaroz, 1 Gil de Atrocillo Avenida, Vinaroz, 12500 Castellón, Spain.
authors.forename: Mara
authors.initials: M
authors.lastname: Albert-Fort
authors.affiliation: Spanish Net of Ophthalmic Pathology OFTARED, Institute of Health Carlos III, 4 Sinesio Delgado Street, 28029 Madrid, Spain ; Ophthalmology Department, University Clinic Hospital, 1 Ramón y Cajal Street, 47005 Valladolid, Spain.
authors.forename: María I
authors.initials: MI
authors.lastname: López-Gálvez
authors.affiliation: Spanish Net of Ophthalmic Pathology OFTARED, Institute of Health Carlos III, 4 Sinesio Delgado Street, 28029 Madrid, Spain ; Ophthalmology Department, University Clinic Hospital, 1 Ramón y Cajal Street, 47005 Valladolid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Galarreta-Mira
authors.affiliation: Ophthalmology Clinic and Research Department, Clinica Oftalmológica Rahhal, 52 Cirilo Amorós Street, 46004 Valencia, Spain.
authors.forename: María F
authors.initials: MF
authors.lastname: García-Esparza
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain ; Spanish Net of Ophthalmic Pathology OFTARED, Institute of Health Carlos III, 4 Sinesio Delgado Street, 28029 Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Galbis-Estrada
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain.
authors.forename: Carla
authors.initials: C
authors.lastname: Marco-Ramirez
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain.
authors.forename: Kian
authors.initials: K
authors.lastname: Shoaie-Nia
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain.
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Sanz-González
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Vila-Bou
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain ; Physiology Department, Faculty of Medicine, University Cardenal Herrera, 1 Seminario Avenida, Moncada, 46113 Valencia, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Bendala-Tufanisco
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain ; Ophthalmology Department, University Hospital Reina Sofía, 1 Intendente Jorge Palacios Avenida, 30003 Murcia, Spain.
authors.forename: José J
authors.initials: JJ
authors.lastname: García-Medina
authors.affiliation: Ophthalmic Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Nucci
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain ; Ophthalmology Department, University and Polytechnic Hospital "La Fe", 106 Fernando Abril Martorell Avenida, 46026 Valencia, Spain ; Spanish Net of Ophthalmic Pathology OFTARED, Institute of Health Carlos III, 4 Sinesio Delgado Street, 28029 Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gallego-Pinazo
authors.affiliation: Retina Division, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Arévalo
authors.affiliation: Ophthalmic Research Unit "Santiago Grisolía", Fundación Investigación Biomédica y Sanitaria (FISABIO), 90 Gaspar Aguilar Avenida, 46017 Valencia, Spain ; Ophthalmology Research Unit, Department of Surgery, Faculty of Medicine and Odontology, University of Valencia, 15 Blasco Ibañez Avenida, 46010 Valencia, Spain ; Spanish Net of Ophthalmic Pathology OFTARED, Institute of Health Carlos III, 4 Sinesio Delgado Street, 28029 Madrid, Spain.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Pinazo-Durán
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000378:metabolism* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood* / Q000378:metabolism / Q000503:physiopathology*; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D041623:Tomography, Optical Coherence / Q000379:methods; D014280:Triglycerides
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D001786:Blood Glucose; D015525:Fatty Acids, Omega-3; D006442:Glycated Hemoglobin; D008315:Malondialdehyde; D014280:Triglycerides