血清Chemerin在糖尿病视网膜病变患者中的表达及临床意义

Expression of serum Chemerin in the diabetic retinopathy patients and its clinical implication

目的：观察糖尿病视网膜病变（ diabetic retinopathy,DR）患者血清Chemerin 水平变化,探讨其在DR发生发展过程中的作用。 方法：采用临床病例对照研究,以2012-01/2013-12期间就诊的90例糖尿病患者为研究对象,分为糖尿病无视网膜病变（ no diabetic retinopathy,NDR）组、单纯型糖尿病视网膜病变（ simple diabetic retinopathy,SDR）组和增殖型糖尿病视网膜病变（ proliferative diabetic retmopathy,PDR）组三组,以健康志愿者（ normal controls,NC）为对照组,采用双抗体夹心法酶联免疫吸附法检测患者血清中Chemerin水平,同时检测TNF-α、脂联素等炎症因子水平,收集患者体重指数、血脂、基础疾病等临床资料。 结果：NC 组、NDR 组、SDR 组和 PDR 组患者血清Chemerin±次为12.35±3.56、26.50±5.34、34.67±7.72、40.97±8.97μg/L,SDR组、PDR血清Chemerin水平明显高于NC组和NDR组,差异有统计学意义（ P〈0.01）,血清Chemerin水平与TNF-α正相关（r=0.8746,P〈0.01）,与脂联素负相关（r=-0.7418,P〈0.01）。 Logistic多元回归分析结果显示,Chemerin为DR独立危险因素之一（ OR=8.458,95%CI：1.611~44.410,P=0.012）。 结论：DR患者血清中Chemerin水平升高,其可能参与了DR的发生发展过程。

AIM： To investigate the level changes of serum Chemerin in patients with diabetic retinopathy （ DR） and explore its role in the development of DR. METHODS： A total of 90 diabetes patients from January 2012 to December 2013 were enrolled, including non-diabetic retinopathy （NDR,n=30）, simple diabetic retinopathy （ SDR, n = 30 ） , proliferative diabetic retinopathy （ PDR, n=30 ） . Thirty healthy persons were included as normal control （ NC） . Chemerin level, tumor necrosis factor-α （ TNF-α） , adiponectin were assessed by enzyme - linked immunosorbent assay. Clinical characters including BMI, underlying diseases, blood lipids ect. were collected. RESULTS：The serum levels of Chemerin in NC, NDR, SDR, and PDR group were 12. 35±3. 56, 26. 50±5. 34, 34. 67±7. 72, 40. 97±8. 97μg/L respectively. The serum levels of Chemerin in SDR and PDR group were significantly higher than those in NC and NDR group（P〈0. 01）. Serum levels of Chemerin positively correlated with TNF-α （ r=0.8746, P 〈 0. 01 ） and negatively correlated with adiponectin （r=-0. 7418,P〈0. 01）. The results of Logistic regression analysis showed that Chemerin was an independent risk factor for DR （OR=8. 458, 95%CI：1.611~44. 410, P=0. 012）. CONCLUSION：The results show that serum Chemerin level is significantly elevated in DR patients, and Chemerin may be involved in the development of DR.