2型糖尿病视网膜病变与FGF19、PEDF相关性的研究

Changes of serum FGF19 and PEDF levels in patients with type 2 diabetic retinopathy

目的观察成纤维细胞生长因子19(FGF19)、色素上皮衍生因子(PEDF)在2型糖尿病视网膜病变(DR)患者血清中表达水平,并探讨其意义。方法选取2型糖尿病患者89例,根据是否合并糖尿病视网膜病变,分为单纯2型糖尿病患者组45例(DM组)和2型糖尿病合并视网膜病变组44例(DR组);同时收集健康体检者40例作为健康对照组(NDM组)。应用酶联免疫吸附法(ELISA法)检测并比较研究对象血清中FGF19、PEDF水平及生化指标,并分析各项指标之间的相关性以及FGF19、PEDF与DR的关系。结果与NDM组比较,DM组及DR组血清FGF19水平降低、PEDF水平升高(P <0. 05)。DR组FGF19低于DM组(P <0. 05),PEDF高于DM组(P <0. 05)。DM、DR组FBG、FINS、Hb A1c、TC、HDL、LDL水平均高于NDM组(P <0. 05),但DM组与DR组组间比较差异无统计学意义(P> 0. 05)。DR组Hcy、TG、CRP水平均高于DM、NDM组,VLDL水平低于DM、NDM组(P <0. 05)。DR患者血清FGF19水平与HDL、CRP呈正相关(r=0. 341、0. 623,P <0. 05),与FBG呈负相关(r=-0. 428,P <0. 05);DR患者血清PEDF水平与FINS呈负相关(r=-0. 343,P <0. 05)。PEDF血清水平>12. 76 mg/L时,诊断为DR的灵敏度为80. 9%,特异度为56. 7%。结论在DR患者中,血清FGF19水平降低,血清PEDF水平升高,两者的变化水平与DR密切相关,可能参与了DR的发生发展。

Objective To observe the expression of FGFl9(fibroblast growth factor 19)and PEDF(pigment epithelium-derived factor)in the serum of type 2 diabetic retinopathy(DR)patients and discuss their significance.Methods Total 89 patients with type 2 diabetes were selected and divided into two groups according to whether they were combined with diabetic retinopathy:45 patients with type 2 diabetes alone(DM group)and 44 patients with type 2 diabetes mellitus combined with retinopathy(DK group).At the same time,40 healthy people were selected as the control group(NDM group).The serum levels of FGFl 9 and PEDF and their biochemical indexes were detected and compared in each group.The correlation between the indexes and the relationship between FGF19,PEDF and DR were analyzed.Results Compared with NDM group,serum FGF19 level in DM group and DR group decreased,while C-reactive protein(CRP)and PEDF level in DM group and DR group increased(P<0.05);serum FGFl9 level in DR group was lower than that inDMgroup,while serum PEDF level was higher than that in DM group(P<0.05).The levels of fasting blood glucose(FBG),fasting insulin levels(FINS),glycosylated hemoglobin(HhAlc),total cholesterol(TC),high density lipoprotein(HDL)and low density lipoprotein(LDL)in DM and DR groups were higher than those in NDM group(P<0.05),hut there was no significant difference between DM group and DH group(P>0.05);the levels of Hey,triacylglycerol(TG)and CRP in DR group were higher than those in DM and NDM group(P<0.05),and the levels of VLDL were lower than those in DM and NDM group(尸<0.05).The level of serum F(;F19 was positively correlated with HI)I,and CRP in patients with DR(r=0.341,0.623,P<0.05),and negatively correlated with fasting hi-ood glu cose(r=-0.428,P<0.05);The level of serum PEDF in patients with DR were negatively correlated with FINS(r=-0.343,P<0.05).When the serum level of PEDF>12.76 mg/L,the sensitivity and specificity of PEDF dignosing DR were 80.9%and 56.7%respectively.Conclusions In patients with DR,serum FGF19 level decreased and serum PEDF1 levels increased.The level of both changes is closely related to DR and may be involved in the development of DR.