{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T06:09:52Z","timestamp":1772431792871,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"\n Background<\/jats:title>\n Diabetic retinopathy (DR) is a common chronic complication of diabetes mellitus. Endothelin-1 (ET-1) has been identified as a key regulator of various ocular functions, including vascular perfusion, aqueous humor dynamics, and retinal ganglion cell survival. Substantial evidence further underscores the critical involvement of ET-1 in the pathogenesis and progression of DR. Elevated ET-1 levels have been reported in patients with DR; however, findings across studies are inconsistent.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n This meta-analysis aimed to statistically evaluate the level of ET-1 in patients with DR.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A systematic literature search was conducted across five electronic databases (PubMed, Web of Science, OVID, Elsevier Science Direct, and Wiley Online Library). The search strategy targeted the terms \u201cEndothelin-1\u201d or \u201cET-1\u201d in conjunction with \u201cDiabetic retinopathy\u201d or \u201cDR\u201d in title and abstract fields. Results are presented as standardized mean differences (SMD) with 95% confidence intervals (CI).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Ten articles (346 cases and 425 controls) were included in the meta-analysis. The results of the meta-analysis indicated that the circulating ET-1 in patients with DR was significantly higher than that of the controls (SMD: 1.73, 95% CI: 0.90, 2.56). Furthermore, circulating ET-1 in patients with DR was also significantly higher than those in healthy individuals or diabetic patients without retinopathy, respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This meta-analysis is the first to systematically assess ET-1 levels in patients with DR. The findings of this study indicate the potential application of ET-1 as a biomarker for monitoring DR progression.<\/jats:p>\n <\/jats:sec>\n \n Systematic Review Registration<\/jats:title>\n \n https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n , identifier CRD420251156225.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2026.1754896","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T05:21:29Z","timestamp":1772428889000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between endothelin-1 and diabetic retinopathy: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Xin","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Endocrinology, First Affiliated Hospital of Soochow University","place":["Suzhou, 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