Photoreceptor layer thinning is an early biomarker for type 2 diabetes: a cohort study in UK Biobank
To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D. This prospective cohort study included 35,024 UK Biobank participants with high-quality optical coherence tomography (OCT) images, excluding individuals with neurological or ocular diseases. Cox p...
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| Published in: | Eye (London) Vol. 39; no. 17; p. 3135 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
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England
01.12.2025
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| ISSN: | 1476-5454, 1476-5454 |
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| Abstract | To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D.
This prospective cohort study included 35,024 UK Biobank participants with high-quality optical coherence tomography (OCT) images, excluding individuals with neurological or ocular diseases. Cox proportional hazard models were used to analyse the association between baseline POS thickness and incident T2D. Risk model improvement was assessed using net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
Among 35,024 participants (mean age, 55.6 years; 54.0% women), 1187 (3.39%) developed T2D during a median follow-up of 13.18 years. A decrease of 5 μm in POS thickness was linked to a 10% higher risk of T2D (HR, 1.10; 95% CI, 1.02-1.18; P = 0.010). Participants in the lowest tertile of POS thickness had a 22% higher T2D risk compared to those in the highest tertile (HR, 1.22; 95% CI, 1.06-1.42; P = 0.007). Adding POS thickness to traditional risk models significantly improved predictive accuracy (NRI, 0.0356; P = 0.010; IDI, 0.0003; P = 0.010).
POS thinning detected by OCT is significantly associated with an increased risk of T2D and improves risk prediction when added to conventional models. These findings suggest that POS thickness may serve as a novel biomarker for early detection of T2D, supporting timely interventions to reduce risk. |
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| AbstractList | To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D.OBJECTIVESTo investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D.This prospective cohort study included 35,024 UK Biobank participants with high-quality optical coherence tomography (OCT) images, excluding individuals with neurological or ocular diseases. Cox proportional hazard models were used to analyse the association between baseline POS thickness and incident T2D. Risk model improvement was assessed using net reclassification improvement (NRI) and integrated discrimination improvement (IDI).METHODSThis prospective cohort study included 35,024 UK Biobank participants with high-quality optical coherence tomography (OCT) images, excluding individuals with neurological or ocular diseases. Cox proportional hazard models were used to analyse the association between baseline POS thickness and incident T2D. Risk model improvement was assessed using net reclassification improvement (NRI) and integrated discrimination improvement (IDI).Among 35,024 participants (mean age, 55.6 years; 54.0% women), 1187 (3.39%) developed T2D during a median follow-up of 13.18 years. A decrease of 5 μm in POS thickness was linked to a 10% higher risk of T2D (HR, 1.10; 95% CI, 1.02-1.18; P = 0.010). Participants in the lowest tertile of POS thickness had a 22% higher T2D risk compared to those in the highest tertile (HR, 1.22; 95% CI, 1.06-1.42; P = 0.007). Adding POS thickness to traditional risk models significantly improved predictive accuracy (NRI, 0.0356; P = 0.010; IDI, 0.0003; P = 0.010).RESULTSAmong 35,024 participants (mean age, 55.6 years; 54.0% women), 1187 (3.39%) developed T2D during a median follow-up of 13.18 years. A decrease of 5 μm in POS thickness was linked to a 10% higher risk of T2D (HR, 1.10; 95% CI, 1.02-1.18; P = 0.010). Participants in the lowest tertile of POS thickness had a 22% higher T2D risk compared to those in the highest tertile (HR, 1.22; 95% CI, 1.06-1.42; P = 0.007). Adding POS thickness to traditional risk models significantly improved predictive accuracy (NRI, 0.0356; P = 0.010; IDI, 0.0003; P = 0.010).POS thinning detected by OCT is significantly associated with an increased risk of T2D and improves risk prediction when added to conventional models. These findings suggest that POS thickness may serve as a novel biomarker for early detection of T2D, supporting timely interventions to reduce risk.CONCLUSIONSPOS thinning detected by OCT is significantly associated with an increased risk of T2D and improves risk prediction when added to conventional models. These findings suggest that POS thickness may serve as a novel biomarker for early detection of T2D, supporting timely interventions to reduce risk. To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D. This prospective cohort study included 35,024 UK Biobank participants with high-quality optical coherence tomography (OCT) images, excluding individuals with neurological or ocular diseases. Cox proportional hazard models were used to analyse the association between baseline POS thickness and incident T2D. Risk model improvement was assessed using net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Among 35,024 participants (mean age, 55.6 years; 54.0% women), 1187 (3.39%) developed T2D during a median follow-up of 13.18 years. A decrease of 5 μm in POS thickness was linked to a 10% higher risk of T2D (HR, 1.10; 95% CI, 1.02-1.18; P = 0.010). Participants in the lowest tertile of POS thickness had a 22% higher T2D risk compared to those in the highest tertile (HR, 1.22; 95% CI, 1.06-1.42; P = 0.007). Adding POS thickness to traditional risk models significantly improved predictive accuracy (NRI, 0.0356; P = 0.010; IDI, 0.0003; P = 0.010). POS thinning detected by OCT is significantly associated with an increased risk of T2D and improves risk prediction when added to conventional models. These findings suggest that POS thickness may serve as a novel biomarker for early detection of T2D, supporting timely interventions to reduce risk. |
| Author | Zhang, Xinyu Liu, Zhenzhen Hu, Leyi Wu, Yue Ma, Yiyuan Zheng, Danying Jin, Guangming |
| Author_xml | – sequence: 1 givenname: Yiyuan orcidid: 0009-0007-6457-5291 surname: Ma fullname: Ma, Yiyuan organization: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China – sequence: 2 givenname: Yue surname: Wu fullname: Wu, Yue organization: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China – sequence: 3 givenname: Leyi surname: Hu fullname: Hu, Leyi organization: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China – sequence: 4 givenname: Xinyu surname: Zhang fullname: Zhang, Xinyu organization: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China – sequence: 5 givenname: Danying surname: Zheng fullname: Zheng, Danying organization: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China – sequence: 6 givenname: Zhenzhen surname: Liu fullname: Liu, Zhenzhen email: liuzhenzhen@gzzoc.com organization: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China. liuzhenzhen@gzzoc.com – sequence: 7 givenname: Guangming orcidid: 0000-0001-9994-6338 surname: Jin fullname: Jin, Guangming email: jingm@mail2.sysu.edu.cn organization: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China. jingm@mail2.sysu.edu.cn |
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| Snippet | To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D.
This prospective cohort study included 35,024 UK... To investigate the association between photoreceptor outer segment (POS) thickness and the risk of T2D.OBJECTIVESTo investigate the association between... |
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| SubjectTerms | Biomarkers - analysis Diabetes Mellitus, Type 2 - diagnostic imaging Diabetes Mellitus, Type 2 - epidemiology Diabetes Mellitus, Type 2 - etiology Female Follow-Up Studies Humans Male Middle Aged Predictive Learning Models - classification Predictive Learning Models - statistics & numerical data Predictive Value of Tests Proportional Hazards Models Prospective Studies Retinal Photoreceptor Cell Outer Segment - pathology Risk Assessment - methods Risk Factors Tomography, Optical Coherence - classification Tomography, Optical Coherence - statistics & numerical data UK Biobank United Kingdom - epidemiology |
| Title | Photoreceptor layer thinning is an early biomarker for type 2 diabetes: a cohort study in UK Biobank |
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