血清Chemerin在糖尿病视网膜病变患者中的表达及临床意义

摘要

AIM: To investigate the level changes of serum Chemerin in patients with diabetic retinopathy ( DR) and explore its role in the development of DR. METHODS: A total of 90 diabetes patients from January 2012 to December 2013 were enrolled, including non-diabetic retinopathy (NDR,n=30), simple diabetic retinopathy ( SDR, n = 30 ) , proliferative diabetic retinopathy ( PDR, n=30 ) . Thirty healthy persons were included as normal control ( NC) . Chemerin level, tumor necrosis factor-α ( TNF-α) , adiponectin were assessed by enzyme - linked immunosorbent assay. Clinical characters including BMI, underlying diseases, blood lipids ect. were collected. RESULTS:The serum levels of Chemerin in NC, NDR, SDR, and PDR group were 12. 35±3. 56, 26. 50±5. 34, 34. 67±7. 72, 40. 97±8. 97μg/L respectively. The serum levels of Chemerin in SDR and PDR group were significantly higher than those in NC and NDR group(P<0. 01). Serum levels of Chemerin positively correlated with TNF-α ( r=0.8746, P < 0. 01 ) and negatively correlated with adiponectin (r=-0. 7418,P<0. 01). The results of Logistic regression analysis showed that Chemerin was an independent risk factor for DR (OR=8. 458, 95%CI:1.611~44. 410, P=0. 012). CONCLUSION:The results show that serum Chemerin level is significantly elevated in DR patients, and Chemerin may be involved in the development of DR.%目的：观察糖尿病视网膜病变( diabetic retinopathy,DR)患者血清Chemerin 水平变化,探讨其在DR发生发展过程中的作用。　　方法：采用临床病例对照研究,以2012-01/2013-12期间就诊的90例糖尿病患者为研究对象,分为糖尿病无视网膜病变( no diabetic retinopathy,NDR)组、单纯型糖尿病视网膜病变( simple diabetic retinopathy,SDR)组和增殖型糖尿病视网膜病变( proliferative diabetic retmopathy,PDR)组三组,以健康志愿者( normal controls,NC)为对照组,采用双抗体夹心法酶联免疫吸附法检测患者血清中Chemerin水平,同时检测TNF-α、脂联素等炎症因子水平,收集患者体重指数、血脂、基础疾病等临床资料。　　结果：NC 组、NDR 组、SDR 组和 PDR 组患者血清Chemerin±次为12.35±3.56、26.50±5.34、34.67±7.72、40.97±8.97μg/L,SDR组、PDR血清Chemerin水平明显高于NC组和NDR组,差异有统计学意义( P<0.01),血清Chemerin水平与TNF-α正相关(r=0.8746,P<0.01),与脂联素负相关(r=-0.7418,P<0.01)。 Logistic多元回归分析结果显示,Chemerin为DR独立危险因素之一( OR=8.458,95%CI：1.611~44.410,P=0.012)。　　结论：DR患者血清中Chemerin水平升高,其可能参与了DR的发生发展过程。