血清Leptin和TNF-α与2型糖尿病视网膜病变的相关关系研究  

Correlation of serum Leptin and TNF-α to type 2 diabetic retinopathy

作　　者：李庆雨 谷淑颖 刘丹[3] 

机构地区：[1]盘锦市第一人民医院眼科,辽宁省盘锦市124010 [2]盘锦市第二人民医院眼科 [3]辽宁医学院附属第一医院眼科,辽宁省锦州市121001

出　　处：《眼科新进展》2009年第8期584-586,590,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨血清中瘦素(Leptin)、肿瘤坏死因子α(tumornecrosis factor-α,TNF-α)的水平与2型糖尿病视网膜病变发生发展之间的关系。方法对88例2型糖尿病患者(按照糖尿病视网膜病变分级标准,再将其分为3个亚组)及30例健康对照者,采用放射免疫法测定血清中Leptin和TNF-α,免疫抑制比浊法测定糖化血红蛋白,记录相关的临床和生化指标。结果2型糖尿病视网膜病变组患者血清Leptin水平(10.57±1.84)μg.L-1显著高于无视网膜病变组的(7.90±1.58)μg·L-1(P<0.01);增生性糖尿病视网膜病变组血清Leptin水平(11.66±1.21)μg.L-1显著高于非增生性糖尿病视网膜病变组的(9.56±1.75)μg.L-1(P<0.01)及无视网膜病变组的(7.90±1.58)μg·L-1(P<0.01)。2型糖尿病视网膜病变组患者血清TNF-α水平(60.45±13.33)pmol·L-1显著高于无视网膜病变组的(39.97±8.38)pmol·L-1(P<0.01);增生性糖尿病视网膜病变组血清TNF-α水平(69.93±10.86)pmol.L-1显著高于非增生性糖尿病视网膜病变组的(51.60±8.47)pmol·L-1(P<0.01)及无视网膜病变组(39.97±8.38)pmol·L-1(P<0.01)。血清Leptin水平与病程、糖化血红蛋白、体质量指数成正相关(r=0.639,P<0.01;r=0.260,P<0.05;r=0.468,P<0.01);血清TNF-α与病程、空腹血糖、体质量指数成正相关(r=0.680、0.355、0.299,P<0.01),与收缩压、舒张压成正相关(r=0.281、0.234,P<0.05),与高密度脂蛋白胆固醇成负相关(r=-0.423,P<0.01)。血清Leptin、TNF-α水平成正相关(r=0.660,P<0.05)。结论2型糖尿病合并糖尿病视网膜病变患者血清Leptin、TNF-α水平增高;随着糖尿病视网膜病变程度的加重,血清中的Leptin、TNF-α水平也逐渐升高,提示其与糖尿病视网膜病变,特别是糖尿病视网膜病变的严重程度相关。Objective To investigate the correlation of serum Leptin and tumor necrosis factor-α（TNF-α） to type 2 diabetic retinopathy（DR）. Methods Eighty-eight type 2 diabetes mellitus patients （ divided into 3 subsets by the classification of the DR） and 30 healthy people were collected. Serum Leptin and TNF-α were measured by radio- immunoassay, hemoglobin Alc was measured by immunosuppressive turbidimetry. The correlated index of biochemistry and clinic were recorded. Results Serum Leptin of type 2 DR group （ 10.57 ± 1.84）μg·L^-1 was significantly higher than that of non DR group （ 7.90 ± 1. 58 ）μg·L^-1 （ P 〈 0.01 ）, and that of proliferative DR group （ 11.66 ± 1. 21 ）μg·L^-1 was obviously higher than that of non proliferative DR group （9. 56 ± 1.75 ）μg·L^-1 and that of non DR group （7.90 ± 1.58 ）μg·L^-1 （ both P 〈 0.01 ）. Serum TNF-α of type 2 DR group （ 60.45 ± 13.33 ） pmol·L^-1 was significantly higher than that of non DR group （ 39.97 ± 8.38 ） pmol ·L^-1 （ P 〈 0.01 ）, and that of proliferative DR group （69.93± 10. 86）pmol·L^-1 was obviously higher than that of non proliferative DR group （ 51.60 ± 8.47 ） pmol·L^-1 and that of non DR group （ 39.97 ± 8.38 ） pmol·L^-1 （ both P 〈 0.01 ）. Serum Leptin levels positively correlated with course, hemoglobin Alc, body mass index（r =0. 639 ,P 〈 0.01 ; r = 0. 260 ,P 〈 0.05 ; r = 0. 468 ,P 〈 0.01 ） ; Serum TNF-α levels positively correlated with course, fasting plasma glucose, body mass index （r = 0.680, r = 0. 355, r = 0. 299 ; all P 〈 0.01 ）, also positively correlated with systolic blood pressure and diastolic blood pressure （ r = 0. 281, r = 0. 234 ; both P 〈 0. 05 ）, but negatively correlated with high density lipoprotein cholestrerol （r= -0.423 ,P 〈 0.01 ）. There was a positive correlation of Leptin to TNF-α （ r = 0. 660, P 〈 0.05 ）. Conclusions The levels of serum Leptin and TNF-α can increase in type 2 diabetes mellitus combined with

关 键 词：糖尿病视网膜病变 瘦素 肿瘤坏死因子Α 2型糖尿病 

分 类 号：R774.1[医药卫生—眼科]