血清单核细胞趋化蛋白-1、8-异前列腺素F2a与2型糖尿病增殖期视网膜病变的关系

The impact of serum monocyte chemotactic protein-1 and 8-iso-prostaglandin F2a on development of proliferative retinopathy in type 2 diabetes

目的糖尿病增殖期视网膜病变(PDR)是导致失明的主要危险因素之一,目前发病机制尚未完全明确。通过研究血清单核细胞趋化蛋白-1(MCP-1)、8-异前列腺素F2a(8-iso-PGF2a)与2型糖尿病PDR的关系,探讨炎症反应和氧化应激在2型糖尿病PDR中的作用机制及临床意义。方法选择2012年6月至12月血压正常的非增殖期和增殖期的2型糖尿病视网膜病变病人106例,其中非增殖期病人50例(NPDR组)和增殖期病人56例(PDR组)。测定血清MCP-1、8-iso-PGF2a、空腹血糖(FBG)、24小时尿微量白蛋白(24hUMA)和糖化血红蛋白(HbA1c),比较它们之间的差异,分析PDR发生的相关危险因素。结果 PDR病人血清中的MCP-1、8-iso-PGF2a和24hUMA明显高于NPDR病人(P均<0.01),血清MCP-1、24hUMA分别与血8-iso-PGF2a呈正相关(r=0.915,0.865,P<0.01)。血清8-iso-PGF2a是24hUMA和血清MCP-1的独立影响因素(β=0.865,0.915;P=0.000)。糖尿病视网膜病变家族史、24hUMA、血清MCP-1、8-iso-PGF2a是PDR病变的独立危险因素(OR=1.21,1.63,1.86,1.57)。结论氧化应激和炎症反应可能共同参与糖尿病PDR的发展,血清MCP-1和8-iso-PGF2a有可能作为预测糖尿病视网膜病变进展的标志物,但尚需大样本的临床研究进一步证实。

Objective Proliferative diabetic retinopathy（PDR） is one of risk factors resulting in blindness and the exact mechanism of its development remains elusive. The aim of our study is to probe into mechanisms and clinical significance of inflammation and oxidative stress in patients with proliferative retinopathy in type 2 diabetes by analyzing the association of serum monocyte chemotactic protein-1（MCP-1） and 8-iso-prostaglandin F2a （8-iso- PGF2a） with proliferative retinopathy in type 2 diabetes. Methods A total of 106 cases of type 2 diabetes were enrolled,in which 56 cases with proliferative retinopathy （PDR group） and 50 cases with non-proliferative （NPDR group） . All of the patients were in normal blood pressure. Serum MCP-1,8-iso-PGF2a,fasting plasma glucose （FPG） ,24-h-urinary microalbumin （24hUMA） ,glycosylated hemoglobin（HbA1c） and the other clinical data were collected and analyzed. Results Serum MCP-1,8-iso-PGF2a and 24hUMA were higher in PDR group than in NPDR group（all P0.01） . Serum MCP-1 and 24hUMA were positively associated with serum 8-iso-PGF2a（r=0. 915,0. 865; P0.01） . Serum 8-iso-PGF2a was an independent influencing factor of serum MCP-1 and 24hUMA （β=0. 865,0. 915,P=0. 000） . History of diabetic retinopathy,serum MCP-1,8-iso-PGF2a and 24hUMA were independent risk factors of PDR（OR=1. 21,1. 63,1. 86,1. 57） . Conclusions Oxidative stress and inflammatory response may be together involved in progress of retinopathy in type 2 diabetes. Serum MCP-1 and 8-iso-PGF2a may be possibly considered as predictors of progress of retinopathy in type 2 diabetes.