血糖控制不佳2型糖尿病视网膜病变患者外周血VEGF、HIF-1α和ET-1水平及其临床意义

Expression of VEGF, HIF-1α and ET-1 in peripheral blood of type 2 diabetic retinopathy patients with poorly controlled blood glucose

摘要:

目的 探讨血糖控制不佳的2型糖尿病视网膜病变（DR）患者外周血中血管内皮生长因子（VEGF）、缺氧诱导因子-1α（HIF-1α）和内皮素-1（ET-1）水平与视网膜病变的关系。方法 选取2012年1月— 2018年2月在首都医科大学附属复兴医院住院并符合WHO 2型糖尿病（T2DM）诊断标准的T2DM患者195例为研究对象，分为3组：血糖控制较好且无DR的患者62例作为观察1组，血糖控制较好的DR患者 65例作为观察2组，以及血糖控制不佳的DR患者68例作为观察3组。选择同期健康体检者64例为正常对照组。检测所有受试者的动态血糖和VEGF、HIF-1α和ET-1，考察VEGF、HIF-1α和ET-1与动态血糖的关系。结果 与正常对照组比较，3个观察组的空腹血糖（FBG）、餐后2?h血糖（2?hPBG）、血糖水平标准差（SDBG）、日内血糖平均波动幅度（MAGE）、日间血糖平均绝对差（MODD）、日内血糖波动次数（NGE）、VEGF、HIF-1α和ET-1均提高（P?<0.05），与观察1组比较，观察2和3组的SDBG、MAGE、MODD、NGE、VEGF、HIF-1α和ET-1均提高（P?<0.05），与观察2组比较，观察3组的SDBG、MAGE、MODD、NGE、VEGF、HIF-1α和ET-1均提高（P?<0.05），观察1、2组的FBG、2 hPBG差异无统计学意义（P?>0.05），观察3组的FBG、2 hPBG均高于观察1、2组（P?<0.05）。VEGF、HIF-1α和ET-1与SDBG、MAGE、MODD和NGE均呈正相关（P?<0.05）。结论 按T2DM发病、DR发生及伴随DR的血糖控制不佳的顺序，VEGF、HIF-1α和ET-1表达逐渐升高，可能参与血糖控制不佳的DR的发生、发展过程。

Abstract:

Objective To investigate the peripheral blood vascular endothelial growth factor (VEGF) and hypoxia-inducible factor-1 alpha (HIF) in patients with type 2 diabetic retinopathy (DR) with poor glycemic control. Methods A total of 195 patients diagnosed as type 2 diabetes mellitus (T2DM) who admitted to our hospital from January 2012 to February 2018 were divided into 3 groups: 62 newly T2DM without DR patients with good controlled blood glucose, as the observation group 1, 65 patients with DR patients with good controlled blood glucose, as the observation group 2 and 68 patients with poorly controlled blood glucose, as the observation group 3. In the same period, 64 healthy people who underwent routine health check-up in our hospital were selected as the healthy group. The dynamic blood glucose, the VEGF, HIF-1α and ET-1 in peripheral blood were examined. The relationship between VEGF, HIF-1α and ET-1 of 4 groups were tested. Results Compared with the healthy group, the fasting blood glucose (FBG), 2 hour postprandial blood glucose (2 hPBG), standard deviation blood glucose (SDBG), mean amplitude of plasma glucose excursions (MAGE), mean of daily difference (MODD) and number of glucose excursions (NGE) of the observation group 1, 2 and 3 had increased (P??0.05). Compared with the observation group 1 and 2, the FBG and 2 hPBG of the observation group 3 had increased (P?