Sex-Related Effects of Gut Microbiota in Metabolic Syndrome-Related Diabetic Retinopathy

Funding Information: G.K. acknowledges lab support provided by grants from the Icelandic Research Fund (217946-051), the Icelandic Cancer Society Research Fund and the University of Iceland Research Fund. A.G.L. acknowledges financial support provided by a Postdoctoral Fellowship grant from the Icelandic Research Fund (217796-052). Publisher Copyright: © 2023 by the authors.The metabolic syndrome (MetS) is a complex disease of metabolic abnormalities, including obesity, insulin resistance, hypertension and dyslipidaemia, and it is associated with an increased risk of cardiovascular disease (CVD). Diabetic retinopathy (DR) is the leading cause of vision loss among working-aged adults around the world and is the most frequent complication in type 2 diabetic (T2D) patients. The gut microbiota are a complex ecosystem made up of more than 100 trillion of microbial cells and their composition and diversity have been identified as potential risk factors for the development of several metabolic disorders, including MetS, T2D, DR and CVD. Biomarkers are used to monitor or analyse biological processes, therapeutic responses, as well as for the early detection of pathogenic disorders. Here, we discuss molecular mechanisms underlying MetS, the effects of biological sex in MetS-related DR and gut microbiota, as well as the latest advances in biomarker research in the field. We conclude that sex may play an important role in gut microbiota influencing MetS-related DR.Peer reviewe