胱抑素C及Chemerin在糖尿病视网膜病变患者血清中表达的临床意义

The Expression and Clinical Significance of Serum Cystatin C and Serum Chemerin in Patients with Diabetic Retinopathy

目的分析胱抑素C及趋化素(Chemerin)在糖尿病视网膜病变患者血清中表达的临床意义。方法选取80例临床确诊的糖尿病视网膜病变患者作为研究对象,其中39例增殖性糖尿病视网膜病变(proliferative diabeticretinopathy,PDR),41例无增殖性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR),以及选取同期的45例单纯糖尿病作为对照组,40例健康体检者作为正常对照组;对比4组研究对象的一般资料、临床和生化指标,包括性别、年龄、体重指数(BMI)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HONA-IR)、空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs CRP)等,以及血清胱抑素C及Chemerin水平,并进行Pearson相关性分析。结果对照组血清胱抑素C及Chemerin水平均显著高于正常对照组,PDR组、NPDR组均显著高于对照组,PDR组均显著高于NPDR组,且血清胱抑素C及Chemerin水平均随着糖尿病视网膜病变程度加大而升高,4组间的血清胱抑素C及Chemerin水平差异均具有统计学意义(均P<0.05);Pearson相关性分析显示:血清胱抑素C水平与收缩压、HbA1c、HONA-IR、FPG、TG、TC、LDL-C呈正相关(均P<0.05),而血清Chemerin水平与糖尿病病程、BMI、HONA-IR、尿白蛋白量、hs CRP呈正相关(均P<0.05);血清胱抑素C与Chemerin水平也呈正相关(P<0.05)。结论血清高水平的胱抑素C及Chemerin共同参与了糖尿病视网膜病变的发生、发展过程,可能与糖代谢障碍有关。

Objective To analyze cystatin C and chemokine（Chemerin） expression and clinical significance in patients of diabetic retinopathy. Methods We selected 80 cases of clinical diagnosis of diabetic retinopathy patients as the research object, among them 39 cases had proliferative diabeticretinopathy （PDR）, 41 cases had non - proliferative diabetic retinopathy （NPDR）. We also inluded 45 cases of simple diabetes for the same period as the control group, and 40 cases of healthy subjects as the normal control group. Gender, age, body mass index （ BMI ）, glycosylated hemoglobin （ HbA1 c ）, insulin resistance index （ HONA - IR ）, fasting plasma glucose （ FPG）, triglycerides （TG） ; total cholesterol （ TC）, low- density lipoprotein cholesterol （ LDL- C）, hypersensitive c-reactive protein （hsCRP）, etc. , and urinary inhibition C and serum Chemerin levels were examined and Pearson correlation analysis was used. Results Serum cystatin C and Chemerin levels were significantly higher in PDR group and NPDR group than that of control group. Serum cystatin C and Chemerin levels in PDR group was significantly higher than that of NPDR group, Serum cystatin C and Chemerin levels increased with the severityof diabetic retinopathy. The differences of serum cystatin C and Chemerin level between the 4 groups were statistically significant （ P 〈 0.05 ） ; Pearson correlation analysis showed that the serum cystatin C level and systolic blood pressure, HbA1 c, HONA-IR, FPG, TG, TC and LDL-C were positively correlated（ P 〈 0.05 ）, while the level of serum Chemerinwas positively with diabetes duration, BMI, HONA- IR, urinary albumin, hsCRP（ P 〈 0.05 ）. Serum cystatin C and Chemerin level was positively correlated （ P 〈 0.05 ）. Conclusion Elevated levels of cystatin C and Chemerinmight berelated toimpaired glucose metabolism and therefore might be involved in the process of the occurrence and development of diabetic retinopathy.