转甲状腺素蛋白和人脂氧素A4在糖尿病视网膜病变患者中的表达及其临床意义

The expression and significance of transthyretin and human lipoxygenin A4 in patients with diabetic retinopathy

目的:探讨转甲状腺素蛋白(TTR)和人脂氧素A4(LXA4)在糖尿病视网膜病变(DR)患者中的表达及其临床意义。方法:选择2015年6月至2017年6月广东医科大学附属医院内分泌科收治的81例DR患者,分为单纯DR(SDR)组和增殖期DR(PDR)组,同期选取糖尿病无视网膜病变(NDR)者50例及健康体检者50例(对照组)。比较各组空腹血糖(FPG)、糖化血红蛋白(HbA1c)及血清超敏C反应蛋白(hs-CRP)、LXA4、TTR、血管内皮生长因子(VEGF)水平,并分析其与DR发生的相关性。结果:SDR组与PDR组血清FPG、HbA1c、hs-CRP、TTR、VEGF水平显著高于对照组和NDR组,而LXA4水平显著低于对照组和NDR组,且PDR组FPG、HbA1c、hs-CRP、TTR、VEGF水平高于SDR组,LXA4水平低于SDR组(均P<0. 05)。Pearson相关分析显示,LXA4与VEGF、FPG、HbA1c、hs-CRP均呈负相关关系,TTR与VEGF、FPG、HbA1c、hs-CRP均呈正相关关系(均P<0. 05)。二项分类Logistic回归分析显示,TTR、LXA4为DR的危险因素(P<0. 05)。结论:LXA4水平降低或TTR水平升高可能为DR发生发展的危险因素。

Objective: To investigate the expression and significance of transthyretin(TTR)and human lipoxygenin A4(LXA4)in patients with diabetic retinopathy(DR). Methods: A total of 81 DR patients in our hospital from June 2015 to 2017 June were selected and divided into simple DR(SDR)group and proliferating DR(PDR)group. 50 cases of non-DR(NDR)and 50 healthy subjects(control group)were selected in the same period. The fasting blood glucose,glycosylated hemoglobin(HbA1 c),hypersensitivity C reactive protein(hs-CRP),LXA4,TTR,and vascular endothelial growth factor(VEGF)levels were compared,and the correlation between these indexes and the occurrence of DR was analyzed. Results: The serum FPG,HbA1 c,hs-CRP and TTR levels of SDR and PDR groups were higher than those of the control group and NDR group,while the LXA4 level was significantly lower(P<0. 05),and the changes were more marked in PDR group compared with SDR group(P<0. 05). There was a significant difference in the course of disease,FPG,HbA1 c and hs-CRP between group SDR and group PDR(P<0. 05). Pearson correlation analysis showed that LXA4 was negatively correlated with VEGF,FPG,HbA1 c,hs-CRP and TTR,and TTR was positively correlated with VEGF,FPG,HbA1 c and hs-CRP(P<0. 05). Logistic regression analysis showed that TTR and LXA4 were risk factors for DR(P<0. 05). Conclusion: The LXA4 level decreased or the TTR level increased may be the risk factor for DR.