血清和房水核心蛋白多糖水平与糖尿病视网膜病变的关系

Serum and aqueous humor decorin level change in patients with diabeticretinopathy and their relationship with disease progression

目的:分析血清和房水核心蛋白多糖(decorin, DCN)水平与糖尿病视网膜病变(DR)的关系。方法:纳入2020年2月至2021年10月中国人民解放军空军第986医院收治的133例2型糖尿病(T2DM)患者,根据眼科检查结果分为非DR组(n=39)和DR组(n=94),另纳入同期35例白内障患者作为对照组。使用酶联免疫吸附夹心法检测血清和房水DCN水平。结果:DR组血清和房水DCN水平显著高于对照组和非DR组(P<0.001)。经Spearman及多元线性回归分析,房水DCN水平与DM病程及血清DCN水平均呈正相关(r值分别为0.200、0.360,P<0.05)。经多因素Logistic回归分析,血清DCN水平为T2DM患者发生DR的独立预测因素(P<0.05)。重度非增殖性DR及增殖性DR患者的血清DCN水平[5 811.91(3 815.93,10 613.32)ng·ml-1]显著高于轻度非增殖性DR[3 733.28(2 292.13,4 700.71)ng·ml-1]及中度非增殖性DR患者[4 071.26(2 815.29,6 487.09) ng·ml-1](F=10.861,P<0.001)。经受试者工作特征曲线分析,血清DCN水平诊断T2DM患者是否发生DR的曲线下面积(AUC)为0.732(95%CI:0.645~0.818),同样诊断重度非增殖性DR及增殖性DR的AUC为0.732(95%CI:0.617~0.846)。结论:血清和房水DCN水平与DR的发生和进展呈正相关,血清DCN可作为临床上预测DR发生和进展相关的生物标志物。

Objective:To analyze the changes of serum and aqueous humor decorin(DCN)level in patients with diabetic retinopathy(DR)and its relationship with disease progression.Methods:133 patients with type 2 diabetes mellitus(T2DM)admitted to the 986th Hospital of the Chinese People's Liberation Army Air Force from February 2020 to October 2021 were enrolled.According to the ophthalmic examination results,they were divided into non-DR group(n=39)and DR group(n=94),and 35 cataract patients in the same period were included into control group.Enzyme-linked immunosorbent sandwich method was used to detect serum and aqueous humor DCN levels.Results:The serum and aqueous humor DCN levels in DR group were significantly higher than those in control group and non-DR group(P<0.001).Based on Spearman and multiple linear regression analysis,the log aqueous humor DCN level was positively correlated with the course of DM and the log serum DCN level(r=0.200,0.360,P<0.05).Multivariate Logistic regression analysis showed that log serum DCN level was an independent predictor of DR in T2DM patients(P<0.05).The serum DCN level of severe NPDR and PDR patients[5811.91(3815.93,10613.32)ng·ml-1]was significantly higher than that of mild NPDR patients[3733.28(2292.13,4700.71)ng·ml-1]and moderate NPDR patients[4071.26(2815.29,6487.09)ng·ml-1](F=10.861,P<0.001).According to multivariate Logistic regression analysis,the area under the curve(AUC)of serum DCN level for diagnosing the occurrence of DR in T2DM patients was 0.732(95%CI:0.645-0.818),and the AUC for diagnosing severe non-proliferative DR and proliferative DR was 0.732(95%CI:0.617-0.846).Conclusion:Serum and aqueous humor DCN levels are positively correlated with the occurrence and progression of DR,and serum DCN can be used as a biomarker to predict the occurrence and progression of DR better in clinical practice.