重视基于代谢异质性的糖尿病视网膜病变早期诊断和精准防治研究  

The opportunities of metabolic windows for early diagnosis and precise prevention and treatment of diabetic retinopathy

作　　者：张芳[1] 许迅[1] Zhang Fang;Xu Xun(Department of Ophthalmology,Shanghai General Hospital,Shanghai Jiao Tong University School of Medicine,Institute of Ophthalmology,Shanghai Jiao Tong University,Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院眼科,上海交通大学眼科研究所,200080

出　　处：《中华实验眼科杂志》2022年第1期1-5,共5页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金(92057106)。

摘　　要：糖尿病是多病因引起的慢性代谢性疾病,糖尿病视网膜病变(DR)是糖尿病的主要眼部并发症,是导致工作年龄人群不可逆盲的代谢性眼病。目前全球糖尿病患病率明显增加,且因DR早期导致的眼底血管神经单元病变无明显体征而常常延误诊疗,故DR的早期诊断和防控面临着巨大挑战。现阶段DR的早期临床预测指标具有较好的预测和防控DR发生发展的价值,如糖化血红蛋白和血糖,但仍缺乏对糖尿病代谢异质性及其潜在诱发DR的病理作用研究。代谢组等多组学研究方法及深度学习技术是研究疾病病理生理过程的有力工具,可用于阐明DR的代谢特征,是发现早期生物标志物、代谢新途径和确立防治靶点的重要抓手。未来的DR诊疗应注重遗传背景和环境因素导致的患者代谢重塑诱发DR,将疾病发生和发展的临床指标测定与组学数据分析方法相结合,发现可预警DR早期发病的生物标志物和干预靶点,实现DR的早期预测和精准防控。Diabetes mellitus(DM)is a chronic metabolic disease caused by multiple etiologies.Diabetic retinopathy(DR),as a primary ocular complication of DM,is the leading cause of blindness among working-age adults in the world.With the rapid increase of diabetes incidence worldwide,the diagnosis of DR is often delayed because few symptoms of the retinal vessel-nurse unit lesion are found in early DR.Therefore,the early diagnosis,prevention and treatment of DR are facing much more challenges.At present,the early clinical biomarkers of DR,such as glycosylated hemoglobin and blood glucose,are of great value in predicting and preventing the occurrence and development of DR,but there is still a lack of research on the pathological effect of metabolic heterogeneity and its potential induction of DR.Multi-omics methods,such as metabolomics and single-cell transcriptome,as well as deep learning techniques,are powerful tools for the study of DR pathophysiological processes,which can be used to reveal the metabolic characteristics of DR,discover early biomarkers and new metabolic pathways and identify targets for treatment.Future advances which aim to diagnose and treat DR should consider the metabolic remodeling induced by genetic background and environmental factors comprehensively,combine omics approaches and the measurement of clinical indicators of DR occurrence and development to find biomarkers of early DR and targets so as to achieve early prediction and accurate prevention of DR.

关 键 词：糖尿病视网膜病变 代谢组学 生物标志物 代谢异质性 预防和治疗 靶点 

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