Hepatorenal Biomarkers and their Association with Retinopathy in an Adult Population: a Case-Control Study

Background: Diabetes mellitus is a major risk factor for retinopathy globally, and as such, research has predominantly focused on glycaemic control as central to retinopathy prevention and management. However, emerging pieces of evidence suggest a possible involvement of the hepatorenal system in the pathophysiology of retinopathy. Despite the plausible pathophysiological link, the specific association between hepatorenal biochemical markers and the presence of retinopathy remains inadequately explored, particularly within the Ghanaian population. Methods: This case-control study utilised secondary data from the Tamale Teaching Hospital in Ghana, which were collected from February to August 2025. The study involved 438 adults, comprising 142 (32.4%) persons diagnosed with retinopathy, with 186 (42.5%) being males. The participants were aged from 20 to 88 years, who had undergone a comprehensive ophthalmological evaluation and for whom complete laboratory data on hepatic and renal function variables were available. Results: Results showed significant disparities in hepatic and renal variables between the retinopathy and control groups. However, after adjusting for covariates and possible confounders the levels (multivariable regression coefficient, P-value) of albumen (0.058, 0.022), GGT (0.030, < 0.001), total bilirubin (0.089, < 0.001) and direct bilirubin (0.218, < 0.001) were higher while creatinine (-0.010, 0.038), ALT (-0.038, 0.001), and indirect bilirubin (-0.263, < 0.001) levels were lower in the retinopathy group. Conclusion: The study identifies hepatic and renal biochemical disparities associated with retinopathy in the study population. This profile likely reflects the possible involvement of the liver and kidney in the pathophysiology of retinopathy. However, further studies are recommended to validate these results.