糖尿病视网膜病变与降钙素基因相关肽及内皮素的关系

Relations Between Diabetic Retinopathy and Calcitonin Gene Related to Peptide and Endothelin in Diabetes Mellitus

目的 :探讨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 6 0例糖尿病患者及 30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 (GHb A1 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。糖尿病患者分为 2 0例无糖尿病视网膜病变组 (DM 组 )、2 2例非增殖期糖尿病视网膜病变组 (DM 组 )及 18例增殖期糖尿病视网膜病变组 (DM 组 )。应用 x± s、t检验、直线相关分析等统计学方法分析实验数据。结果 :糖尿病患者 CGRP水平明显低于对照组 (P<0 .0 5 ) ,DM 组降低特别显著 (P<0 .0 1)。DM各组 ET水平均增高 ,但 DM 组与对照组比较无统计学意义 (P>0 .0 5 ) ,DM 组与对照组比较显著增高 ,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与 CGRP显著减少。

Objective: To study the relations between diabetic retinopathy (DR) and calcitonin gene related to peptide (CGRP) and endothelin (ET) in diabetes mellitus. Methods: The concentrations of calcitonin gene related to peptide and Endothelin were determined in 30 normal subjects (C group) and 60 diabetic patients (DM group) by radioimmunoassay. The DM group was divided into three groups: 20 cases of non diabetic retinopathy group (DMⅠgroup);22 cases of background diabetic retinopathy group (DMⅡ group);18 cases of proliferative diabetic retinopathy group (DMⅢgroup). Results: The concentrations of calcitonin gene related to peptide in diabetes mellitus group were lower than that of C group ( P <0.05), the CGRP in DM Ⅲ group was markedly lower than that of C group ( P <0.01). ET concentration in diabetes mellitus was elevated than that in C group, but without statistical significance in DMⅠgroup ( P >0.05). The ET in DM Ⅲ group was higher than that of C group ( P <0.01).There was negatively correlated in plasma CGRP with ET in diabetes mellitus. Conclusion: These results suggested that the lower CGRP level might be a factor in causing diabetic retinopathy. The decreased level of CGRP and increased level of ET were related to the diabetic retinopathy.