血浆内皮素和非酯化脂肪酸改变与糖尿病视网膜病变的关系

Changes of Plasma Endothelin and Nonesterified Fatty Acids and Diabetic Retinopathy

目的：为探讨血浆内皮素（ＥＴ）和非酯化脂肪酸（ＮＥＦＡ）水平与糖尿病视网膜病变（ＤＲ）的关系。方法：分组分析了５６例伴和不伴ＤＲ的２型糖尿病（ＤＭ）人血浆ＥＴ和ＮＥＦＡ水平，并与正常人进行了比较。结果：２型ＤＭ病人血浆ＥＴ水平明显高于正常人，伴有ＤＲ组病人又明显高于无ＤＲ的病人。病人血浆ＮＥＦＡ总水平和亚油酸（Ｃ１８：２ｎ－６）、油酸（Ｃ１８：１ｎ－９）、软脂酸（Ｃ１６：０）和硬脂酸（Ｃ１８：０）含量明显高于对照组，伴有ＤＲ的病人油酸和总酸水平又明显高于不伴ＤＲ组病人。血浆ＮＥＦＡ水平与ＥＴ浓度呈明显正相关。结论：血管内皮损伤，ＥＴ释放增加和ＮＥＦＡ代谢紊乱是糖尿病ＤＲ发生的重要因素。

objective:To study the relationship between plasma endothelin (ET) and nonesterified fatty acids(NEFA) and diabetic retinopathy(DR). Methods plasma ET and NEFA were examined in 56 noninsulin-dependent diabetes mulitus(NIDDM) patients with or without retinopathy and 30 controls. Results:The results showed that plasma ET levels in NIDDM were significantly higher than those in the healthy controls, and patients with DR had a higher plasma ET level compared to those without DR. The contents of stearic(C18:0), oleic(C18:1n-9), linoleic (C18:2n-6) and plamitic (C16:0) acids were significantly increased in diabetic patients, and the plasma contents of total NEFA and oleic acids were higher in patients with DR than those without DR. Plasma NEFA levels were positively correlated with ET concentrations in NIDDM patients. Conclusion: These results suggest that increase of plasma EF levels result from vascular endothelial cell injury and abnormalities of plasma NEFA metabolism may be one im portant cause of diabetic retimopathy.