血清可溶性肿瘤坏死因子受体与2型糖尿病视网膜病变相关性研究

Association between sTNFR and diabetic retinopathy in type 2 diabetic patients

目的研究血清可溶性肿瘤坏死因子受体(soluble tumor necrosis factor receptor,s TNFR)与2型糖尿病视网膜病变的相关性。方法 66例2型糖尿病患者通过眼底检查和眼底荧光血管造影按照EDTRS分期分为3组:无糖尿病视网膜病变(no diabetic retinopathy,NDR;n=22)组、非增殖型糖尿病视网膜病变(nonproliferative diabetic retinopathy,NPDR;n=24)组和增殖型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR;n=20)组。21名健康人作为对照组。检测4组研究对象血清中肿瘤坏死因子(tumor necrosis factor,TNF)-α、s TNFR-1、s TNFR-2水平。组间统计分析采用非参数Mann-Whitney U检验。结果血清中TNF-α中位数分别为:对照组0 pg·m L^(-1)、NDR组3.45 pg·m L^(-1)、NPDR组3.92 pg·m L^(-1)、PDR组8.12 pg·m L^(-1)。对照组与PDR组(P<0.001)、NDR组与PDR组(P=0.008)比较差异均有统计学意义。血清中s TNFR-1水平中位数:对照组1.50ng·m L^(-1)、NDR组1.88 ng·m L^(-1)、NPDR组2.58 ng·m L^(-1)、PDR组3.00 ng·m L^(-1)。对照组与NPDR组(P<0.001)、对照组与PDR组(P<0.001)、NDR组与NPDR组(P=0.007)、NDR组与PDR组(P<0.001)比较,差异均有统计学意义。血清中s TNFR-2中位数分别为:对照组3.88 ng·m L^(-1)、NDR组5.01 ng·m L^(-1)、NPDR组5.21 ng·m L^(-1)、PDR组6.33 ng·m L^(-1)。除了NDR组与NPDR组(P=0.070)间差异无统计学意义外,其他组间差异均有统计学意义(均为P<0.05)。结论血清中s TNFR与2型糖尿病视网膜病变密切相关,表明s TNFR在糖尿病视网膜病变的发生发展中起到了一定的作用。对s TNFR进行进一步研究可以寻找治疗糖尿病视网膜病变新的靶点。

Objective To investigate the associations of serum levels of soluble tumor necrosis factor receptor（ s TNFR） with diabetic retinopathy in type 2 diabetic patients. Methods A cross-sectional design was utilized for this study. 66 patients with type 2 diabetes underw ent fundus examination or fundus fluorescein angiography according to the Early Treatment Diabetic Retinopathy Study（ EDTRS） and were divided into three groups： no diabetic retinopathy（ NDR,n= 22）,non-proliferative diabetic retinopathy（ NPDR,n = 24） and proliferative diabetic retinopathy（ PDR,n = 20）. 21 healthy subjects were enrolled for control group. Serum levels of tumor necrosis factor（ TNF）-α,s TNFR-1 and s TNFR-2 were analyzed. Statistical analysis was performed using nonparametric Mann-Whitney U test. Results The median serum TNF-α levels was 0 pg·m L-1in control group,3. 45 pg·m L-1in NDRgroup,3. 92 pg·m L-1in NPDRgroup and 8. 12 pg · m L-1in PDRgroup. Statistical significances were found between control group and PDRgroup（ P 〈 0. 001）,NDRgroup and PDRgroup（ P = 0. 008）. The median serum s TNFR-1 levels was 1. 50 ng·m L-1in control group,1. 88 ng·m L-1in NDRgroup,2.58 ng·m L-1in NPDRgroup and 3. 00 ng·m L-1in PDRgroup. Statistical significances were found between control group and NPDRgroup（ P 〈 0. 001）,control group and PDRgroup（ P〈 0. 001）,NDRgroup and NPDRgroup（ P = 0. 007）,NDRgroup and PDRgroup（ P 〈 0.001）. The median serum s TNFR-2 levels was 3. 88 ng · m L-1in control group,5. 01 ng ·m L-1in NDRgroup,5. 21 ng ·m L-1in NPDRgroup and 6. 33 ng ·m L-1in PDRgroup.Statistical significances were found between all groups（ P 〈 0. 05）,except between group NDRgroup and NPDRgroup（ P = 0. 07）. Conclusion The serum levels of s TNFR-1,s TNFR-2,TNF-αare highly correlated with DRin type 2 diabetic patients,suggesting that s TNFRmay play an important role in the development of DR. Research for s TNFRmay be able to find a new therapeutic targets for DR.