Trial reportJournal of diabetes and its complications2022
The obesity paradox: Retinopathy, obesity, and circulating risk markers in youth with type 2 diabetes in the TODAY Study.
Trial report in Journal of diabetes and its complications, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Risk factors for the occurrence and progression of diabetic retinopathy in children and adolescents: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Growth Hormone Mediators and Glycemic Control in Youths With Type 2 Diabetes: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2024Trial
- Obesity-associated lysosomal nitrosative stress promotes retinopathy.Biology direct · 2026Article
- Association between free triiodothyronine, resting metabolic rate, systemic immune-inflammation index levels and diabetic retinopathy in type 2 diabetic patients with euthyroidism.Frontiers in endocrinology · 2026Article
- Association Between Hormone Levels and Retinopathy in Patients With Type 2 Diabetes: A Cross-Sectional Study.Translational vision science & technology · 2025Article
- Insulin-like Growth Factor-Binding Protein-1 (IGFBP-1) as a Biomarker of Cardiovascular Disease.Biomolecules · 2024Review
- Major adverse events in youth-onset type 1 and type 2 diabetes: The SEARCH and TODAY studies.Diabetes research and clinical practice · 2024Article
- Article
Corrections and comments
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Authors and funding
10 authors at 9 institutions in 1 country.
Funding
Abstract
aimTo understand the relationship of obesity and 27 circulating inflammatory biomarkers to the prevalence of non-proliferative diabetic retinopathy (NPDR) in youth with type 2 diabetes.
methodsYouth with type 2 diabetes who participated in the TODAY (Treatment Options for Type 2 Diabetes in Adolescents and Youth) study were followed for 2-6.5 years. Digital fundus photographs were obtained in the last year of the study. Blood samples during the study were processed for inflammatory biomarkers, and these were correlated with obesity tertiles and presence of retinopathy.
resultsHigher BMI was associated with an increase in circulating levels of metabolic biomarkers including high sensitivity C-reactive protein (hsCRP), plasminogen activator inhibitor 1 (PAI-1), fibrinogen, LDL-cholesterol (LDL-C) and Apolipoprotein B (ApoB), tumor necrosis factor receptors 1 and 2 (TNFR-1 and -2), interleukin 6 (IL-6), E-selectin, and homocysteine, as well as a decrease in the metabolic risk markers HDL-cholesterol (HDLC), and insulin-like growth factor binding protein 1 (IGFBP-1). Although NPDR risk decreased with increasing obesity, it was not associated with any of the measured biomarkers.
conclusionsCirculating levels of measured biomarkers did not elucidate the "obesity paradox" of decreased NPDR in the most obese participants in the TODAY study.
trial registrationclinicaltrials.govNCT00081328.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.