糖尿病视网膜病变阳虚病机的代谢组学物质基础

Study on yang deficiency mechanism of diabetic retinopathy based on metabonomics

目的利用系统生物学技术初步探索糖尿病视网膜病变(DR)阳虚病机的代谢组学基础,以期科学地阐释阳虚病机主导DR病情进展的作用机制。方法符合2型糖尿病诊断的DR患者89例,按中医症状分组为无阳虚证组和有阳虚证组,以正常健康者30例作对照,应用气相色谱/飞行时间质谱联用技术(GC/TOFMS)进行血浆全代谢组学检测,建立DR及正常人的血浆代谢组指纹图谱,并对潜在生物标志物进行分析。结果DR各组和正常人的代谢指纹图谱分类结果显示,DR有阳虚证组和无阳虚证组基本分离,较少重叠,结合载荷图,DR阳虚证组与无阳虚组分类的潜在标记物按贡献率从大到小依次为17.197,8.28,4.717,15.31,2.277,12.683。结论 DR阳虚证与无阳虚证的代谢组指纹图谱具有一定差异,阳虚可能通过影响机体能量代谢致使机体内环境发生重大变化,从而导致DR病情进展。

OBJECTIVE To explore metabonomics material basis of yang deficiency pathogenesis of DR and to explain the pathogenesis of yang deficiency leading DR progress. METHODS Patients with type 2 diabetes mellitus and healthy volunteer were collected in same living district. Eighty-nine DR and 30 normal subjects were screened under the inclusive criterion and its information database including the special questionnaire and experi- mental tests was recorded. These patients were divided in 2 groups as the difference of yang deficiency. Gas chro- matography/time-of-flight mass spectrometry （GC/TOFMS） and multivariate statistical analysis had been used for the analysis of blood serum metabolic profiling. RESULTS The discrimination of metabonomics outcomes among the different groups showed that yang deficiency and non-yang deficiency groups were basically separated with few overlap, The potential biological markers for yang deficiency classification belonged to 17.197, 8.28, 4.717, 15.31, 2.277 and 12.683. CONCLUSIONS Yang deficiency and non-yang deficiency groups in metabolomics fingerprints had some differences. The essence might be due to the organism energy metabolism inducing internal environment great changes. Yang deficiency pathogenesis was the key influence to DR progress.