糖尿病视网膜病变患者血清Gas6和SDF-1的检测及意义  

Assay of serum growth arrest-specific gene product 6 and stromal cell-derived factor isoform-1 in patients with diabetic retinopathy

作　　者：曹艺[1] 安美霞[1] 许汉春[1] 李雁[1] 鲁志卿[1] 桑璇[1] 刘彦利[1] 

机构地区：[1]南方医科大学第三附属医院眼科,广州510630

出　　处：《中华实验眼科杂志》2014年第6期536-540,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：广东省医学科学技术研究基金项目（A2010357）;南方医科大学第三附属医院院长基金项目（B2011001）

摘　　要：背景 糖尿病视网膜病变（DR）是常见的糖尿病微血管并发症之一,发病机制复杂.研究表明生长停滞特异性基因产物6（Gas6）/TAM系统参与了糖尿病及其并发症的发生,而2型糖尿病患者基质细胞衍生因子1（SDF-1）表达水平发生改变,但血清Gas6/TAM系统和SDF-1是否参与DR的发生尚不明确.目的 比较正常人和糖尿病患者血清Gas6和SDF-1水平的变化,探讨其在DR发病过程中的作用.方法 采用前瞻性队列研究方法,于2013年1-8月收集在南方医科大学第三附属医院诊治的糖尿病患者90例,按1987年中华医学会糖尿病视网膜病变分期标准将患者分为增生型DR（PDR）组、单纯型DR（BDR）组、糖尿病无视网膜病变（NDR）组,每组30例,另纳入同期在医院进行健康体检的正常志愿者30名.收集正常志愿者和糖尿病患者外周血2 ml,检测受试者白细胞和中性粒细胞计数及血清甘油三酯（TG）、总胆固醇（CHOL）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平.采用ELISA法检测受试者血清中Gas6、SDF-1α和SDF-1β水平,比较正常志愿者与DR患者上述检测指标的差异,并分析患者血清中Gas6、SDF-1α和SDF-1β质量浓度与血细胞及血脂水平的关系. 结果 正常对照组、NDR组、BDR组和PDR组血清中CHOL分另为4.93 （4.14,5.44）、5.02（4.35,5.69）、4.54（3.85,5.93）和5.99（5.11,6.89） mmol/L,其中PDR组血清中CHOL浓度明显高于正常对照组、NDR组和BDR组,差异均有统计学意义（P=0.002、0.007、0.006）.正常对照组、BDR组白细胞计数高于PDR组（P=0.034、0.015）,BDR组中性粒细胞计数高于PDR组（P=0.024）,NDR组HDL-C高于PDR组（P=0.032）.PDR组LDL-C水平高于正常对照组（P=0.032）.与正常对照组相比,NDR组和BDR组患者血清Gas6水平明显下降,差异均有统计学意义（P=0.048,P=0.006）,而PDR组患者血清Gas6水平高于BDR组,但差异无统计学意义（P=0.297）.Background Diabetic retinopathy （DR） is a progressive vision-threatening complication of diabetes mellitus （DM）,but its pathogenic mechanism is still unclear.Researches showed that growth arrest-specific gene product 6 （Gas6） /TAM system participates in pathogenesis and development of DR,and stromal-derived factors （SDF） vary in 2-type DM patients.However,whether Gas6/TAM and SDF-1 are associated with DR is below understood.Objective This study was to determine the relationship between the staging of DR and the levels of serum Gas6,SDF-1α and SDF-1β in DM patients.Methods A prospective cohord study was designed in this study.Ninety 2-type DM patients were included in the 3rd Affiliated Hospital of Southern Medical University Hospital from January to August in 2013.The patients were grouped into the non-diabetic retinopathy （NDR） group,background DR group （BDR） and proliferative DR （PDR） group,with 30 for each group.Thirty normal volunteers were enrolled in the same hospital and same period.The periphery blood 2 ml was collected from all the subjects under the consent inform.The levels of serum Gas6,SDF-1α and SDF-1β were assayed by ELISA,and leukocytes,neutrophils,plasma triglycerides （TG）,total cholesterol （CHOL）,high density lipoprotein cholesterol （H DL-C） and low density lipoprotein cholesterol （LDL-C） levels were detected and compared among the 4 groups.The correlations of serum Gas6,SDF-1 α and SDF-1 β changes with blood inflammatory cells and blood lipid were analyzed.Results The plasma CHOL concentrations were 4.93（4.14,5.44）,5.02（4.35,5.69）,4.54（3.85,5.93） and 5.99（5.11,6.89）mmol/L in the normal control group,NDR group,BDR group and PDR group,respectively,and the blood CHOL concentrations were significantly higher in the PDR group than those of the normal control group,NDR group,BDR group （P =0.002,P =0.007,P =0.006）.White blood cell counts in the normal control group,BDR group were higher than those of the PDR group （P =0.034,P =0.0

关 键 词：生长停滞特异性基因产物6 基质细胞衍生因子1 糖尿病 并发症 糖尿病视网膜病变 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]