2型糖尿病视网膜病变患者血清25(OH)D3血管内皮生长因子整合素αvβ3的表达

The expression of serum 25(OH)D3,vascular endothelial growth factor,integrinαvβ3 in patients with type 2 diabetic retinopathy

目的研究2型糖尿病患者血清25(OH)D3、血管内皮生长因子(VEGF)、整合素αvβ3的水平及在预测糖尿病视网膜病变(DR)发生发展中的临床意义。方法选取2019-03-06在郑州大学第二附属院住院的189例T2DM患者,分为无DR组(NDR组52例)和有DR组(DR组137例),收集2组临床资料,检测血清25(OH)D3、VEGF、整合素αvβ3的表达水平。结果血清25(OH)D3水平与年龄、BMI、HbA1c、FINS、FPG、VEGF、整合素αvβ3、有无糖尿病视网膜病变均呈明显负相关,VEGF与整合素αvβ3呈正相关(均P<0.05);病程、BMI、SBP、整合素αvβ3水平水平是DR的危险因素,25(OH)D3是DR的保护因素;当VEGF及整合素αvβ3分布大于预测界值24.22 pg/mL和5.19 ng/mL时,ROC曲线下面积分布为0.60(95%CI 0.503~0.696)、0.671(95%CI 0.571~0.771),预测价值最大。结论随着DR的发展,血清25(OH)D3水平逐渐降低,VEGF水平逐渐升高,整合素αvβ3水平随之升高,提示25(OH)D3、VEGF、整合素αvβ3共同参与了DR的发生、发展。

Objective To study the serum 25(OH)D3,vascular endothelial growth factor(VEGF)and integrinαvβ3 levels in patients with type 2 diabetes and their clinical significance in predicting the development of diabetic retinopathy(DR).Methods From March to June 2019,189 T2DM patients admitted to the Department of Endocrinology of the Second Affiliated Hospital of Zhengzhou University were divided into non-DR patients(52 in the NDR group)and DR patients(137 in the DR group).General clinical data were collected and the expression levels of serum 25(OH)D3,VEGF and integrinαvβ3 were detected.Results Serum 25(OH)D3 levels were significantly negatively correlated with age,BMI,HbA1c,FINS,FPG,VEGF,integrinαvβ3,and the presence or absence of diabetic retinopathy.VEGF was positively correlated with integrinαvβ3,all P<0.05;duration,the levels of BMI,SBP,and integrinαvβ3 are risk factors for DR,and 25(OH)D3is a protective factor for DR.When the distribution of VEGF and integrinαvβ3 is greater than the predicted cut-off values of 24.22 pg/mL and 5.19 ng/mL,ROC The area distribution under the curve is 0.60(95%CI 0.503-0.696),0.671(95%CI 0.571-0.771),and the predicted value is the largest.Conclusion With the continuous development of DR,serum 25(OH)D3 levels gradually decrease,VEGF levels gradually increase,andαvβ3 levels increase accordingly,suggesting that 25(OH)D3,VEGF,and integrinαvβ3 participate in the occurrence and development of DR.