糖尿病视网膜病变患者血清Gas6、SDF-1α和SDF-1β变化及意义

Expression changes and clinical significances of Gas6,SDF-1α and SDF-1β in serum in patients with diabetic retinopathy

目的:探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者血清中生长停滞特异基因6(growth arrest specific gene 6,Gas6)、基质细胞衍生因子(stromal cell-derived factor-1,SDF-1)和SDF-1β表达的变化及临床意义。方法:DR患者113例分为增殖性组(n=45)和非增殖性组(n=68),同期选取未合并DR糖尿病患者作为糖尿病组(49例)和健康者42例,检测血糖、血脂和超敏C-反应蛋白(highly sensitive C-reactive protein,hs-CRP)指标,利用实时荧光定量PCR技术检测血清中Gas6、SDF-1α和SDF-1β基因表达。结果:糖尿病组、非增殖性组和增殖性组患者稳态模型的胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)、甘油三酯(triglycerides,TG)和hs-CRP均逐渐升高,差异均有统计学意义(F=39.672、81.625、99.872,均P<0.05),增殖性组和非增殖性组患者低密度脂蛋白(low-density lipoprotein,LDL-C)均高于糖尿病组和健康者,而高密度脂蛋白(high density lipoprotein,HDL-C)均低于糖尿病组和健康者,差异均有统计学意义(F=51.974、43.824,均P<0.05);增殖性组、非增殖性组和糖尿病组患者血清Gas6 mRNA表达量均高于健康者,增殖性组患者血清SDF-1αmRNA表达量均高于非增殖性组、糖尿病组和健康者,增殖性组和非增殖性组患者血清SDF-1βmRNA表达量均高于糖尿病组和健康者,且增殖性组患者高于非增殖组,差异均有统计学意义(F=15.381、21.589、38.942,P<0.05);Pearson相关分析显示,DR患者血清Gas6 mRNA表达量与TG、总胆固醇(total cholesterol,TC)和LDL-C呈正相关(r=0.228、0.241、0.209,均P<0.05),血清SDF-1αmRNA和SDF-1βmRNA表达量均与hs-CRP呈正相关(r=0.297、0.325,P<0.05)。结论:DR患者血清中Gas6、SDF-1α和SDF-1β基因表达水平升高,可能与患者血脂代谢异常及炎性反应有关。

AIM：To investigate the expression changes and clinical significances of Gas6, SDF-1α and SDF-1β in serum in patients with diabetic retinopathy（DR）. METHODS： Totally 113 patients with DR were divided into proliferative group（n=45）and nonproliferative group（n=68）. In the same period, 49 cases of patients with non-contracted DR diabetes were selected as the diabetic group and 42 cases of healthy subjects were selected. The indexes of blood glucose, blood lipids and hs-CRP were detected. The expressions of Gas6, SDF-1α and SDF-1β genes in serum were detected by using real-time PCR technology. RESULTS： The HOMA-IR, TG and hs-CRP in the diabetic group, nonproliferative group and proliferative group gradually increased, the differences were statistically significant（F=39.672, 81.625, 99.872, all P〈0.05）. The LDL-C in the nonproliferative group and proliferative group were higher than the diabetic group and healthy subjects, while the HDL-C were lower than the diabetic group and the healthy subjects, the differences were statistically significant（F=51.974, 43.824, all P〈0.05）. The relative expression levels of Gas6 mRNA in proliferative group, nonproliferative group and diabetic group were higher than the healthy subjects; the relative expression levels of SDF-1α mRNA in proliferative group were higher than the nonproliferative group, diabetic group and healthy subjects. The relative expression levels of SDF-1β mRNA in proliferative group and nonproliferative group were higher than the diabetic group and healthy subjects, and the proliferative group were higher than the nonproliferative group, the differences were statistically significant（F=15.381, 21.589, 38.942, all P〈0.05）. Pearson correlation analysis showed that the relative expression levels of Gas6 mRNA in serum in patients with DR were positively correlated with TG, TC and LDL-C（r=0.228, 0.241, 0.209, all P〈0.05）, and the relative expression levels of SDF-1α mRNA and SDF-1β mRNA in serum were positively correlated with hs-CRP（r=0.297 and 0.325, all P〈0.05）. CONCLUSION： The expression levels of Gas6, SDF-1α and SDF-1β genes in serum in patients with DR are elevated. They might be related to abnormal blood lipid metabolism and inflammatory response.