血清基质金属蛋白酶9蛋白水平与糖尿病视网膜病变关系的研究

The correlation between MMP-9and diabetic retinopathy

目的探讨血清中基质金属蛋白酶9(MMP-9)水平与DR的关系,为阐明DR发病机制提供依据。方法选取2015年10月至2016年10月于大连大学附属中山医院内分泌科就诊的患者120例,包括IGR患者(IGR组),单纯T2DM患者(T2DM组),非增殖性糖尿病视网膜病变患者(NPDR组),增殖性糖尿病视网膜病变患者(PDR组),每组各30例。另选取同期健康体检者30名作为正常对照(NC)组。ELISA测定各组外周血清MMP-9蛋白水平。Spearman相关性分析血清MMP-9蛋白水平与其他指标的相关性,多元线性回归分析血清MMP-9蛋白水平的影响因素。结果与NC组比较,IGR组MMP-9蛋白水平差异无统计学意义(P>0.05),T2DM组、NPDR组及PDR组升高[(197.08±49.90)vs(238.47±52.18)vs(245.06±46.27)ng/ml,P<0.05]。Spearman相关性分析显示,MMP-9蛋白水平与糖尿病病程、胰岛素使用时间、FPG、HbA1c呈正相关,与年龄、BMI、SBP、DBP、TG、TC、LDL-C无相关性。多元线性回归分析结果显示,糖尿病病程、FPG、应用胰岛素时间是血清MMP-9蛋白水平的影响因素。结论血清MMP-9蛋白水平随DR病情加重而升高,呈正相关,提示MMP-9蛋白可能参与DR的发生发展。

Objective To investigate the correlation between diabetic retinopathy（DR）and the serum level of matrix metalloproteinases-9（MMP-9）protein,and to provide experimental basis for elucidating the pathogenesis of DR. Methods A total of 120 patients were enrolled in this study from the Department of Endocrinology,Zhongshan Hospital affiliated to Dalian University from Oct 2015 to Oct2016.All the patients were divided into 4 groups：IGR group（n=30）,T2 DM group（n=30）,nonproliferative diabetic retinopathy group（NPDR group,n=30）and proliferative diabetic retinopathy group（PDR group,n=30）.In addition,30 healthy persons were selected as control（NC）group.The level of MMP-9 protein in peripheral blood was tested by ELISA.The correlation between serum MMP-9 protein level and other indexes was analyzed by Spearman correlation analysis.Multivariate linear regression analysis was used to analyze the influencing factors for serum MMP-9 protein level. Results There was no significant difference in MMP-9 protein levels between IGR group and NC group（P〉0.05）.The MMP-9 protein levels increased successively in T2 DM,NPDR and PDR groups[（197.08±49.90）vs（238.47±52.18）vs（245.06±46.27）ng/ml,P〈0.05].Spearman correlation analysis showed that the level of MMP-9 protein was positively correlated with diabetes duration,the years of insulin therapy and HbA1 c,and not correlated with age,BMI,SBP,DBP,TG,TC or LDL-C.Multiple linear regression analysis showed that the duration of diabetes mellitus and the years of insulin therapy were influencing factors for serum MMP-9 protein level. Conclusion The serum level of MMP-9 protein increased with the DR worsening.The positive correlation between MMP-9 protein and DR suggested that serum MMP-9 protein involved in the progress of DR.