糖尿病视网膜病变患者血清Chemerin 水平变化及在病情评估中的意义

Serum level changes of Chemerin in patients with diabetic retinopathy and its significance in condition assessment

摘要:

目的 探讨糖尿病视网膜病变（DR）患者血清Chemerin 水平变化及在病情评估中的意义。方法 选取2型糖尿病患者142 例，根据检查结果将患者分为非DR 组（n =53）、非增生型DR 组（n =47）和增生型DR 组（n =42），同期，选取健康者40 例作为对照组，收集临床资料，检测血清Chemerin、白细胞介素6（IL-6）和肿瘤坏死因子α（TNF-α）水平，分析DR 病程与该指标的相关性，及DR 患者血清Chemerin 水平与其他指标的相关性，利用受试者工作特征曲线（ROC）分析血清Chemerin 在预测DR 病程进展中的价值。结果 增生型DR 组患者病程、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）及低密度脂蛋白（LDL-C）均高于其他3 组，且非增生型DR 组> 非DR 组> 对照组，而高密度脂蛋白（HDL-C）则呈从增生型DR 组到对照组依次递增趋势，差异有统计学意义（P <0.05）；增生型DR 组患者血清Chemerin、IL-6 和TNF-α 水平均高于非增生型DR 组、非DR 组和对照组，且非增生型DR 组> 非DR 组> 对照组，差异有统计学意义（P <0.05）；排除其他各指标的影响后，DR 病程与Chemerin、IL-6、TNF-α、HbA1c 及LDL-C 呈正相关，而与HDL-C 呈负相关（r ' =0.582、0.531、0.498、0.348、0.335 和-0.352，均P <0.05）；Pearson 相关分析显示，DR患者血清Chemerin 水平与病程、IL-6、TNF-α、HbA1c 及LDL-C 均呈正相关（r =0.359、0.643、0.667、0.504 和0.482，均P <0.05）；ROC 曲线分析显示，当Chemerin=38.9 μg/L 时，敏感性为72.0%，特异性为83.0%。结论 DR患者血清Chemerin 水平升高，且与病程有关，可作为早期预测增生型DR 的辅助指标。

Abstract:

Objective To investigate the serum level changes of Chemerin in patients with diabetic retinopathy (DR) and its significance in condition assessment. Methods A total of 142 cases with type 2 diabetes were selected.Patients were divided into non-DR group (n = 53), non-proliferative DR group (n = 47) and proliferative DR group (n =42) according to the test results. In the same period, 40 healthy subjects were selected for control group. Clinical data were collected. Serum levels of Chemerin, interleukin -6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected.The correlations between DR course and other indicators were analyzed with multivariate analysis. The correlations between serum levels of Chemerin in patients with DR and other indicators were analyzed with Pearson analysis. The value of serum Chemerin in predicting progression of DR was analyzed with receiver operating characteristic curve (ROC curve). Results The course, fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG) and low density lipoprotein (LDL-C) in proliferative DR group were higher than those in non-proliferative DR group, non-DR group and the control group; and the indicator levels in non-DR group were higher than the control group, but were lower than non-proliferative DR group; while the high density lipoprotein (HDL-C) increased more in the control group compared with the proliferative DR group, the difference was statistically significant (P < 0.05). The serum levels of Chemerin, IL-6 and TNF-α in the proliferative DR group were higher than the non-proliferative DR group, non-DR group and control group, and the indicator levels in non-DR group were higher than the control group, but were lower than non-proliferative DR group, the differences were statistical significance (P < 0.05). After excluding the impact of other indicators, the course of DR was positively correlated with Chemerin,IL-6, TNF-α, HbA1c and LDL-C, but was negatively correlated with HDL-C (r' = 0.582, 0.531, 0.498, 0.348, 0.335 and -0.352, all P < 0.05). Pearson correlation analysis showed that the serum levels of Chemerin in patients with DR were positively correlated with disease progression, IL-6, TNF-α, HbA1c and LDL-C (r = 0.359, 0.643, 0.667, 0.504 and 0.482, all P < 0.05). ROC curve analysis showed that when Chemerin equaled 38.9 μg/L, the sensitivity was 72.0% and the specificity was 83.0%. Conclusion The serum level of Chemerin in patients with DR was significantly increased,and was related with course of disease. It could be used as aided index for early prediction of proliferative DR.