血清VEGF、IL-6、SDF-1在糖尿病新生血管性青光眼分期患者中的表达及与CXCR-7、IGF-1的相关性分析

Serum expression of VEGF, IL-6, and SDF-1 in different stages of diabetic NVG and their correlation with CXCR-7 and IGF-1

摘要:

目的 探讨血清血管内皮生长因子（VEGF）、白细胞介素-6（IL-6）、基质细胞源性因子-1（SDF-1）在糖尿病新生血管性青光眼（NVG）分期患者中的表达及与CXC趋化因子受体7（CXCR-7）、胰岛素样生长因子-1（IGF-1）的相关性。方法 选取2019年1月—2024年1月中国人民武装警察部队特色医学中心收治的86例糖尿病NVG患者为研究对象（NVG组），并根据糖尿病NVG临床表现分为Ⅰ、Ⅱ、Ⅲ期。选取同期在该院进行治疗的白内障患者50例为对照组。采用酶联免疫吸附试验检测患者血清VEGF、IL-6、SDF-l、CXCR-7、IGF-1水平。比较不同分组间血清VEGF、IL-6、SDF-l、CXCR-7、IGF-1水平。采用Pearson相关性分析血清VEGF、IL-6、SDF-l与CXCR-7、IGF-1水平的相关性。采用受试者工作特征（ROC）曲线分析血清VEGF、IL-6、SDF-l、CXCR-7、IGF-1对糖尿病NVG Ⅲ期的诊断价值。结果 NVG组患者血清VEGF、IL-6、SDF-l、CXCR-7、IGF-1水平均高于对照组（P <0.05）。随NVG患者临床分期增加，血清VEGF、IL-6、SDF-l、CXCR-7、IGF-1水平随之升高（P <0.05）。血清VEGF、IL-6、SDF-1与CXCR-7水平呈正相关（r =0.325、0.422、0.462，P <0.05），血清VEGF、IL-6、SDF-1与IGF-1水平呈正相关（r =0.215、0.281、0.320，P <0.05）。ROC曲线结果表明，血清VEGF、IL-6、SDF-1、CXCR-7、IGF-1联合诊断糖尿病NVG Ⅲ期的曲线下面积为0.985，敏感性为100.0%（95% CI：0.782，1.000），特异性为91.5%（95% CI：0.825，0.968）。结论 血清VEGF、IL-6、SDF-1在糖尿病NVG患者中呈高表达，且水平随临床分期增加而升高；三者与CXCR-7、IGF-1呈正相关。联合检测这5项指标的诊断效能最高，其中SDF-1是辅助诊断的敏感指标。

Abstract:

Objective To investigate the expression of serum vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), and stromal cell-derived factor 1 (SDF-1) in different stages of diabetic neovascular glaucoma (NVG) and their correlations with CXC chemokine receptor 7 (CXCR-7) and insulin-like growth factor-1 (IGF-1).Methods A retrospective study was conducted on 86 patients diagnosed with diabetic NVG at the Characteristic Medical Center of the Chinese People's Armed Police Force from January 2019 to January 2024. Patients were divided into NVG stages I, II, and III based on clinical manifestations. Fifty patients with cataracts treated during the same period served as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum levels of VEGF, IL-6, SDF-1, CXCR-7, and IGF-1. Serum levels of these markers were compared among different groups. Pearson correlation analysis was employed to evaluate the correlations of serum VEGF, IL-6, and SDF-1 levels with serum CXCR-7 and IGF-1 levels of VEGF, IL-6, and SDF-1 with those of CXCR-7 and IGF-1. Receiver operating characteristic (ROC) curves were used to analyze the diagnostic value of these markers for stage III diabetic NVG.Results Serum levels of VEGF, IL-6, SDF-1, CXCR-7, and IGF-1 in the NVG group were significantly higher than those in the control group (all P < 0.05). Serum levels of these markers increased with the progression of NVG stages (all P < 0.05). Serum VEGF, IL-6, and SDF-1 levels were positively correlated with CXCR-7 levels (r = 0.325, 0.422, 0.462, P < 0.05), and also positively correlated with IGF-1 levels (r = 0.215, 0.281, 0.320, P < 0.05). ROC curve analysis showed that the combined detection of serum VEGF, IL-6, SDF-1, CXCR-7, and IGF-1 yielded an AUC of 0.985, with a sensitivity of 100.0% (95% CI: 0.782, 1.000) and a specificity of 91.5% (95% CI: 82.5, 96.8).Conclusion Serum VEGF, IL-6, and SDF-1 are elevated in patients with diabetic NVG, and their levels increase with advancing clinical stage. These factors are positively correlated with CXCR-7 and IGF-1. Combined detection of these five indicators has the highest diagnostic efficacy for stage III diabetic NVG, with SDF-1 serving as a sensitive auxiliary diagnostic marker.