Background: Diabetic retinopathy (DR) is a significant complication of type 2 diabetes, often leading to vision impairment or blindness. Early and accurate diagnosis is essential for effective management. Serum microRNAs have shown promise as potential biomarkers for Diabetic Retinopathy (DR). Methods: Eighty individuals were categorized into four groups, including healthy controls, diabetic patients without retinopathy (NDR), patients with non-proliferative DR (NPDR), and patients with proliferative DR (PDR). Results: Serum miR-1281 levels showed a significant up-regulation in disease group compared with healthy control. The serum miR-1281 expression in healthy control group were (0.957) which were drastically lower than those in non-diabetic retinopathy (NDR) group (1.56), NPDR group (2.992) and PDR group (8.732), respectively with P< 0.001. The best cutoff of miRNA 1281-fold change for diagnosis of proliferative retinopathy and non-proliferative diabetic retinopathy (NPDR) was ≥3.085, ≥1.598 respectively with area under curve 0.931, 0.933 sensitivity 90%,85% specificity 86.7%,80% positive predictive value 69.2%, 68% negative predictive value 96.3%, 91.4%, accuracy 87.5%, 81.7% (p < 0.001) respectively. There was a statistically significant positive correlation between miRNA 1281-fold change and each of age, platelet count, fasting blood glucose, HbA1c, fasting insulin, HOMA-IR, urea, creatinine, UACR, total cholesterol, LDL and triglycerides. Among factors significantly correlated to miRNA 1281-fold change among patients with non-proliferative DR, only HOMAIR significantly independently associated with non-proliferative DR (unstandardized β=0.428, p=0.005). Conclusion: Serum miR-1281 as a potential biomarker could be related to not only occurrence but also progression for DR in patients with T2D. |