趋化素、肿瘤坏死因子-α与2型糖尿病视网膜病变的相关性  

Correlation analysis of chemerin,TNF-α with type 2 diabetic retinopathy

作　　者：翟红艳[1] 王亚娇 

机构地区：[1]宝鸡市金台医院,陕西省宝鸡市721000 [2]琼海市人民医院,海南省琼海市571400

出　　处：《眼科新进展》2015年第7期667-669,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨2型糖尿病视网膜病变(type 2 diabetic retinopathy,T2DR)患者血清中趋化素(chemerin)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及其临床意义。方法将160例研究对象分为增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)组40例,非增殖性糖尿病视网膜病变(non-proliferative diabetic retinopathy,NPDR)组40例,单纯糖尿病(diabetes mellitus,DM)组患者40例以及健康对照(normal controls,NC)组40例。观察4组研究对象的体检指标,并检测空腹胰岛素、血糖、血脂、糖化血红蛋白及血清中chemerin、TNF-α等含量。计算稳态模型评估的胰岛素抵抗指数(insulin resistance index,HOMA-IR)。结果 DM组[chemerin为(3.83±0.46)mg·L-1、TNF-α为(37.69±5.07)ng·L-1]、NPDR组[chemerin为(4.68±0.74)mg·L-1、TNF-α为(40.69±5.90)ng·L-1]、PDR组[chemerin为(5.86±1.29)mg·L-1、TNF-α为(44.17±6.63)ng·L-1]血清中chemerin、TNF-α水平均较NC组[chemerin为(2.01±0.54)mg·L-1、TNF-α为(22.60±9.78)ng·L-1]升高,且随着DR病情的进展逐渐升高,差异均有统计学意义(均为P<0.05)。相关分析显示血清中chemerin水平与收缩压、空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、胰岛素抵抗指数均呈正相关(r=0.331、0.361、0.251、0.348、0.306、0.523、0.644,均为P<0.05);血清中TNF-α水平与收缩压、舒张压、空腹血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、胰岛素抵抗指数均呈正相关(r=0.299、0.159、0.605、0.262、0.407、0.282、0.619、0.809,均为P<0.05);血清中chemerin与TNF-α水平呈正相关(r=0.738,P<0.05)。结论血清中chemerin和TNF-α水平的升高是T2DR的危险因子,可能共同参与了T2DR的发生发展。Objective To investigate the changes of serum chemerin and TNF-α levels in type 2 diabetic retinopathy（ T2DR）,and explore its significance. Methods The 160 participants were divided into four groups： proliferative diabetic retinopathy group（ PDR group,n = 40）,non-proliferative diabetic retinopathy group（ NPDR group,n = 40）,diabetes mellitus（ DM group,n = 40）,and normal persons served as controls group（ NC group,n = 40）. The physical exanimated was performed for each case. Serum levels of fasting insulin,fasting plasma glucose,blood-fat,glycated hemoglobin,chemerin,TNF-α were measured. Insulin resistance index（ HOMA-IR） was also calculated. Results The serum chemerin,TNF-α levels in DM group were（ 3. 83 ± 0. 46）mg·L- 1,（ 37. 69 ± 5. 07） ng·L- 1,NPDR group were（ 4. 68 ± 0. 74） mg·L- 1,（ 40. 69 ± 5.90） ng·L- 1,PDR group were（ 5. 86 ± 1. 29） mg·L- 1,（ 44. 17 ± 6. 63） ng·L- 1,NC group were（ 2. 01 ± 0. 54） mg·L- 1,（ 22. 60 ± 9. 78） ng·L- 1,the chemerin,TNF-α levels gradually increased as the diabetic retinopathy disease progressed（ all P〈0. 05）. Correlation analysis showed that chemerin were positive related with SBP,FPG,TG,TC,LDL-C,HbA 1c,HOMA-IR（ r= 0. 331,0. 361,0. 251,0. 348,0. 306,0. 523,0. 644,all P〈0. 05）,TNF-α were positive related with SBP,DBP,FPG,TG,TC,LDL-C,HbA 1c,HOMA-IR（ r = 0. 299,0. 159,0. 605,0. 262,0.407,0. 282,0. 619,0. 809,all P〈0. 05）,and chemerin was positive related with TNF-α（ r = 0.738,P〈0. 05）. Conclusion The increase levels of chemerin and TNF-α are the chief risk fac-tors of T2 DR,may be involved in the occurrence and development of T2 DR.

关 键 词：糖尿病视网膜病变 趋化素 肿瘤坏死因子-Α 

分 类 号：R587.2[医药卫生—内分泌]