糖尿病患者视网膜病变与降钙素基因相关肽及内皮素的关系

Relationship between diabetic retinopathy and calcitonin gene related peptide and endothelin in diabetes mellitus

目的 观察糖尿病患者视网膜病变与降钙素基因相关肽 (CGRP)及内皮素 (ET)的关系。方法 应用眼底血管荧光造影法、放射免疫计数法、微柱层析法等观察 60例糖尿病患者 (DM组、DMⅠ～Ⅲ组 )及 3 0例正常对照者的降钙素基因相关肽 (CGRP)、内皮素 (ET)、糖化血红蛋白 (GHbA1 C)、胰岛素 (Ins)、C肽 (CP)、空腹血糖 (FBG)、2 4h尿白蛋白(UAER)、α1 -微球蛋白 (α1 -MG)等指标 ,并进行统计分析。结果 糖尿病患者CGRP水平明显低于对照组 (P <0 0 5 ) ,DMⅢ组降低特别显著 (P <0 0 1)。DM各组ET水平均增高 ,但DM组、DMⅠ组与对照组比较无统计学意义 (P >0 0 5 ) ,DMⅢ组与对照组比较差异有显著性 (P <0 0 1)。CGRP与ET水平存在直线负相关关系。结论 CGRP水平降低可能是糖尿病视网膜病变的致病作用因素之一 ,增殖期糖尿病视网膜病变可能与CGRP显著减少。

Objective To study the relationship between diabetic retinopathy (DR) and calcitonin gene related peptide (CGRP) or endothelin (ET) in diabetes mellitus. Methods\ The concentration of calcitonin gene related peptide and endothelin was determined in 30 normal subjects(group C) and 60 diabetic patients(DM group) by radioimmunoassay . The DM group was sub-divided into three groups: 20 cases of non diabetic retinopathy group (DM groupⅠ); 22 cases of background diabetic retinopathy group (DM groupⅡ); 18 cases of proliferative diabetic retinopathy group (DM group Ⅲ).Results\ The concentration of calcitonin gene related peptide in diabetes mellitus group was lower than that in group C( P <0 05), the CGRP in DM group Ⅲ was markedly lower than that in group C ( P <0 01).The development of diabetic retinopathy was associated with lower CGRP level. ET in diabetes mellitus was higher than that in group C, but was not significantly increased in DM group and DM group Ⅰ( P >0 05). The ET in DM group Ⅲ was markedly higher than that in group C( P <0 01). There was a positive correlation between serum ET and Ins in diabetes mellitus There was a negative correlation between CGRP and ET in diabetes mellitus. Conclusion\ Depressed CGRP may be related diabetic retinopathy. Marked decrease in CGRP and increase in ET may be associated with diabetic retinopathy.