Background The generation of advanced glycosylation end products (AGEs) is one of the most important characteristics in diabetes mellitus (DM).Its role in diabetic eye disease is still unclear.Objective This study was to investigate the changes of AGE levels in human cataractous lens in diabetic patients and further explore the relationship of lens AGEs with early diabetic retinopathy (DR).Methods This study protocol was approved by Ethic Committee of He Eye Hospital.A cases controlled clinical study was carried out.Forty human nuclei were obtained from 40 cataract patients during the phacoemulcification in He Eye Hospital from August to December 2014,with the nuclear hardness of Ⅲ-Ⅳ grades (Emery grading).The eyes were divided into non-DM (NDM) group and DM group,and the DM group was further divided into non-DR (NDR) group,non-proliferative DR (NPDR) group and proliferative DR (PDR) group.Lens AGE level was quantitatively detected by ELISA.Results The content of pentosidine was (31.90±5.00),(35.83±4.22) and (38.59±5.11)pg/ml,and that of carboxymethyl lysine (CML) was (18.82±3.84),(19.65±2.12) and (23.77±4.73) μg/L,and that of imidazolone was (13.12±2.71),(14.48±2.01) and (15.37 ±2.74) pg/ml in the NDR group,NPDR group and PDR group,respectively,which was significantly higher than (27.69 ± 1.53) pg/ml,(11.36 ±1.47) μg/L and (10.21 ± 0.54) pg/ml in the NDM group (all at P＜0.01).The contents of pentosidine and CML in the lens were significantly higher in the PDR group than those in the NDR group (all at P＜0.05);while there was no significant differences in the pentosidine content in the lens among the NDR group,NPDR group and PDR group (all at P＞0.05).The positive correlations were found between CML content and pentosidine content (r =0.623,P =0.000),between CML content and imidazolone content (r =0.717,P =0.000) as well as between pentosidine content and imidazolone content (r=0.669,P =0.000).Conclusions The levels of pentosidine,CML and imidazolone in cataractous lens are obviously elevated in the DM patients.The levels of pentosidine and CML in the lens are gradually raised as the aggravation of DR.AGEs might be a potential maker for the assessment of diabetes.%背景 晚期糖基化终末产物(AGEs)的产生是糖尿病(DM)的重要特征之一,其在DM相关眼病中的表达及其意义仍有待研究. 目的 探讨DM性与非DM(NDM)性白内障患者晶状体中AGEs含量的变化,研究其与糖尿病视网膜病变(DR)程度之间的关系.方法 采用病例对照研究方法,于2014年8-12月从在沈阳何氏眼科医院行超声乳化手术的白内障患者中获取40例40眼的晶状体核,核硬度为Ⅲ-Ⅳ级(Emery分级方法).按照患者是否患有DM分为NDM组(10例)和DM组(30例),然后依据糖尿病视网膜病变国际临床标准将DM组分为无DR(NDR)组、非增生期DR(NPDR)组和增生期DR (PDR)组,每个组均为10例.采用ELISA法对各组患者晶状体中AGEs成分进行定量检测和比较. 结果 NDR组、NPDR组和PDR组患者晶状体中戊糖苷素质量浓度分别为(31.90±5.00)、(35.83±4.22)和(38.59±5.11) pg/ml,CML质量浓度分别为(18.82±3.84)、(19.65±2.12)和(23.77±4.73) μg/L,咪唑酮质量浓度分别为(13.12±2.71)、(14.48±2.01)和(15.37±2.74) pg/ml,均明显高于NDM组的(27.69±1.53) pg/ml、(11.36±1.47)μg/L和(10.21±0.54) pg/ml,差异均有统计学意义(均P＜0.01),PDR组患者晶状体中戊糖苷素和羧甲基赖氨酸(CML)质量浓度均明显高于NDR组,差异均有统计学意义(均P＜0.05),而NDR组、NPDR组和PDR组间晶状体中咪唑酮质量浓度的差异均无统计学意义(均P＞0.05).受检患者晶状体核中CML质量浓度与戊糖苷素质量浓度间、CML质量浓度与咪唑酮质量浓度间和戊糖苷素质量浓度与咪唑酮质量浓度间均呈中等正相关(r=0.623、0.717、0.669,均P=0.000). 结论 DM组晶状体中戊糖苷素、CML、咪唑酮含量显著高于NDM组.晶状体AGEs的水平或可作为评估DR程度的指标.
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