糖尿病视网膜病变患者血清脂蛋白相关磷脂酶A2水平变化及其相关因素分析

Changesand related factors of serum lipoprotein associated phospholipase A2 in patients with diabetic retinopathy

目的观察不同时期DR患者血清脂蛋白相关磷脂A2(Lp-PLA2)水平,并进行相关因素分析。方法 160例T2DM患者经眼底照相结果分为无糖尿病视网膜病变(NDR)组、非增殖期糖尿病视网膜病变(NPDR)组、增殖期糖尿病视网膜病变(PDR)组。分别测定FPG、TG、血清Lp-PLA2、血管内皮生长因子(VEGF)水平;对影响血清Lp-PLA2水平的因素进行多重线性回归分析。结果PDR和NPDR组血清Lp-PLA2[(180.90±48.71)vs(153.70±40.61)vs(127.01±37.64)μg/L]、VEGF[(170.34±35.47)vs(146.16±36.01)vs(85.63±24.20)pg/ml]水平与NDR比较,差异均有统计学意义(P<0.01)。PDR组血清Lp-PLA2[(180.90±48.71)vs(153.70±40.61)μg/L]、VEGF[(170.34±35.47)vs(146.16±36.01)pg/ml]水平与NPDR组比较,差异有统计学意义(P<0.01)。糖尿病病程(β=0.135,P<0.05)、HbA1c(β=0.141,P<0.01)、LDL-C(β=0.291,P<0.05)、TG(β=0.347,P<0.05)、VEGF水平(β=0.313,P<0.05)和DR程度(β=0.354,P<0.05)均与Lp-PLA2水平相关。结论 DR患者血清Lp-PLA2水平升高,与病程、血糖、TG、VEGF水平和DR程度密切相关。

Objective To investigate the changes and related factors of serum lipoprotein associated phospholipids A2 （Lp-PLA2）in patients with different stages of diabetic retinopathy. Methods A total of 160 patients with type2 diabetes （T2DM）were enrolled in this study. All the patients were divided into three groups according to the results of fundus photography： non-diabetic retinopathy（NDR） group, non- proliferative diabetic retinopathy （NPDR） group and proliferative diabetic retinopathy （PDR） group. Fasting blood glucose （FPG）,TG and the level of Lp-PLA2 and VEGF were measured in all the selected subjects. The influencing factors for Lp-PLA2 were analyzed by multiple linear regression analysis. Results The levels of Lp-PLA2 was significantly higher in PDR and NPDR group than in NDR group E（180. 90±48. 71） vs （127.01±37.64） μg/L,P%0. 01; （153.70±40. 61） vs （127.01±37.64） μg/L,P 〈0.01]. The level of VEGF was also higher in PDR and NPDR group than in NDR groupm（170.34± 35.47） vs （85.63±24.20） pg/ml,P〈0. 01;（146.16±36.01） vs （85.63±24.20） pg/ml,P〈0. 01]. The levels of Lp-PLA2 [-（ 180.90 ± 48.71） vs （153.70±40. 61） μg/L, P〈0.01] and VEGF E （ 170.34 ±35.47） vs （146.16±36.01） pg/ml,P〈0.01] in PDR group were significantly higher than in NPDR group. The diabetic duration（β= 0. 135, P〈0. 05）, HbA1 c（β= 0. 141, P%0.01）, LDL-C（p= 0. 291, P〈0.05） ,TG（β= 0. 347, P〈0.05）, the level of VEGF （β=0. 313, P〈0.05） and the stage of diabetic retinopathy（β=0. 354,P〈0.05）were significantly correlated with Lp-PLA2. Conclusion The levels of serum Lp-PLA2 is significantly higher in patients with DR, and is closely related to diabetic duration, blood glucose,TG,VEGF and the stageof diabetic retinopathy.