2型糖尿病患者血清中Opticin蛋白的表达与视网膜病变的相关性研究

Correlation research of Opticin protein expression and retinopathy in serum of type 2 diabetic patients

目的探究2型糖尿病患者血清中Opticin蛋白的表达与糖尿病视网膜病变(DR)的相关性。方法选择2015年1月至2017年1月济宁市第一人民医院收治的2型糖尿病患者120例作为研究对象,依据散瞳后直接眼镜、眼底照相或眼底荧光造影检查结果将患者分为糖尿病无DR(NDR)组、非增殖期DR(NPDR)组、增殖期DR(PDR)组,每组40例。比较3组患者高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)水平,并采用免疫组织化学法检测患者血清中Opticin蛋白表达情况,以及1年后3组患者视力变化。结果 3组患者HDL-C、LDL-C、TC、TG水平比较,差异均无统计学意义(P>0.05);3组患者血清肌酐(SCr)、尿素氮(UN)、肾小球滤过率估计值(eGFR)水平比较,差异均有统计学意义(P<0.05);PDR组患者Scr、UN水平最低,eGFR水平最高。PDR组患者血清Opticin蛋白水平均明显低于NDR组、NPDR组,差异均有统计学意义(P<0.05)。血清Opticin蛋白水平与DR、SCr、UN呈负相关(r=-0.311、-0.357、-0.029;P<0.05);与eGFR呈正相关(r=0.302,P<0.05)。血清Opticin蛋白、eGFR水平降低为DR的独立危险因素(P<0.05)。随访1年PDR组患者视力下降率均高于NDR组、NPDR组,差异均有统计学意义(P<0.05)。结论 Opticin蛋白在糖尿病患者血清中表达水平较低,且随视网膜病变程度加重而逐渐降低,为DR的独立危险因素,Opticin蛋白与患者预后有关,可成为评估DR患者预后指标之一。

Objective To explore the relationship between the expression of Opticin protein and diabetic retinopathy (DR) in serum of type 2 diabetic patients.Methods From January 2015 to January 2017,120 type 2 diabetic patients received in department of ophthalmology Jining No.1 Peopel's hospital,were selected as research subject.According to the results directly after the glasses,or fundus photography,fundus fluorescein angiography,the patients were divided into diabetic patients without retinopathy (NDR group),non proliferative diabetic retinopathy (NPDR group) and proliferative diabetic retinopathy (PDR group),40 cases in each group.The levels of high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),total cholesterol (TC) and triacylglycerol (TG) in the three groups were compared,the expression of Opticin protein in the serum of patients was detected by immunohistochemical method,and the changes of vision after 1 year in the three groups were also observed.Results There was no statistically significant difference in HDL-C,LDL-C,TC and TG levels among the three groups (P>0.05).The levels of serum creatinine (Scr),urea nitrogen (UN) and estimated glomerular filtration rate (eGFR) among the three groups had statistically significant difference (P<0.05);the PDR group had the lowest level of Scr and UN,the highest level of eGFR.The difference of serum Opticin protein expression between the three groups was statistically significant (P<0.05).The serum Opticin protein level in PDR group was obviously lower than that in the NDR group and NPDR group with statistically significant difference (P<0.05).There was a negative correlation between serum Opticin protein level and DR,Scr and UN ( r =-0.311,-0.357,-0.029,P<0.05),and positively correlated with glomerular filtration rate ( r =0.302,P<0.05).The decrease of serum Opticin protein and the decrease of eGFR level were independent risk factors for DR (P<0.05).After 1 years of follow-up,the decrease rate of visual acuity in group PDR was higher than that in NDR group and NPDR group with statistically significant difference (P<0.05).Conclusion Serum Opticin protein in the patients with diabetes is in lower expression,with the severity of retinopathy decreased gradually,as the independent risk factors of diabetic retinopathy,and Opticin protein,which could be one of the indicators of patients with diabetic retinopathy after assessment,is associated with the prognosis of the patients.