AGEs及脂质代谢紊乱与糖尿病视网膜病变的关系

Relations of AGEs and dyslipidemia with diabetic retinopathy

目的 :探讨高级糖基化终末产物 (AGEs)及脂质代谢紊乱与糖尿病视网膜病变 (DR)的关系。方法 :对 35例 2型糖尿病并发 DR患者、 31例 2型糖尿病无 DR(NDR)患者及 16例正常人的血清 AGEs水平及脂质代谢各项指标进行检测。结果 :1DR组及 NDR组患者的血清 AGEs水平均较正常人显著升高 (P<0 .0 5 ) ,DR组患者的血清 AGEs水平较 NDR组增高 ,但差异无统计学意义 (P>0 .0 5 ) ;2 NDR组患者的血清低密度脂蛋白 (L DL- C)水平显著高于正常人 (P<0 .0 5 ) ,血清高密度脂蛋白 (HDL- C)、载脂蛋白 A1(APOA1)水平较正常人显著降低 (P<0 .0 5 ) ,DR组患者血清总胆固醇 (TCH)、甘油三脂 (TG)、 L DL- C水平均显著高于正常人(P<0 .0 5 ) ;3DR患者的血清 TCH、HDL- C及 L DL- C水平较 NDR组显著升高 (P<0 .0 5 ) ;4多因素线性相关分析显示血清 AGEs水平与血清 TCH、 TG、 APOB和 L DL- C水平呈正相关 (r值分别为 0 .70 5、 0 .5 1、 0 .6 0和0 .6 0 )。结论 :AGEs大量生成和堆积、脂质代谢紊乱及二者间的相互作用是 2型糖尿病患者并发 DR的重要危险因素 ,严格控制血糖的同时积极纠正脂质代谢紊乱 ,对于延缓和控制 DR的发生发展具有重要意义。

Objective To discuss the relationship between advanced glycation end produts (AGEs) and dyslipidemia and the onset of diabetic retinopathy (DR). Methods The serum AGEs and lipids levels were examined in 35 patients with type Ⅱ diabetes complicated with DR,31 patients with type Ⅱ diabetes without DR (NDR) and 16 normal subjects.Results ①The serum AGEs levels in DR group and NDR group were significantly higher than that in normal group (P<0.05). The serum AGEs level in DR group was higher than that in NDR group (P<0.05), but the difference was not significant. ②The serum LDL-C level in NDR group was remarkably higher compared with normal group (P<0.05), while the serum HDL-C and APOA1 levels in NDR group were significantly decreased compared with normal group (P<0.05). In DR group, the serum TCH,TG, and LDL-C levels were higher than those in normal group notably (P<0.05). ③The serum TCH, HDL-C, and LDL-C levels in DR group were significantly higher than those in NDR group (P<0.05). ④Linear correlative analysis showed that the serum AGEs level was positively related with the serum TCH, TG, LDL-C, and APOB levels(r values were 0.705, 0.51, 0.60, and 0.60, respectively). Conclusion The generation and accumulation of AGEs, dyslipidemia, as well as the interaction of them are important risk factors for the onset of DR in type Ⅱ diabetic patients. Strict control of blood glucose level and correction of dyslipidemia should be carried out simultaneously, so that the onset and progression of DR can be postponed and controlled more effectly.