糖尿病视网膜病变患者血清Gas6、SDF-1α和SDF-1β变化及意义

摘要

AIM:To investigate the expression changes and clinical significances of Gas6,SDF-1α and SDF-1β in serum in patients with diabetic retinopathy (DR).METHODS:Totally 113 patients with DR were divided into proliferative group (n=45) and nonproliferative group (n=68).In the same period,49 cases of patients with non-contracted DR diabetes were selected as the diabetic group and 42 cases of healthy subjects were selected.The indexes of blood glucose,blood lipids and hs-CRP were detected.The expressions of Gas6,SDF-1α and SDF-1β genes in serum were detected by using real-time PCR technology.RESULTS:The HOMA-IR,TG and hs-CRP in the diabetic group,nonproliferative group and proliferative group gradually increased,the differences were statistically significant (F=39.672,81.625,99.872,all P<0.05).The LDL-C in the nonproliferative group and proliferative group were higher than the diabetic group and healthy subjects,while the HDL-C were lower than the diabetic group and the healthy subjects,the differences were statistically significant (F=51.974,43.824,all P<0.05).The relative expression levels of Gas6 mRNA in proliferative group,nonproliferative group and diabetic group were higher than the healthy subjects;the relative expression levels of SDF-1α mRNA in proliferative group were higher than the nonproliferative group,diabetic group and healthy subjects.The relative expression levels of SDF-1β mRNA in proliferative group and nonproliferative group were higher than the diabetic group and healthy subjects,and the proliferative group were higher than the nonproliferative group,the differences were statistically significant (F=15.381,21.589,38.942,all P<0.05).Pearson correlation analysis showed that the relative expression levels of Gas6 mRNA in serum in patients with DR were positively correlated with TG,TC and LDL-C (r=0.228,0.241,0.209,all P<0.05),and the relative expression levels of SDF-1α mRNA and SDF-1β mRNA in serum were positively correlated with hs-CRP (r=0.297 and 0.325,all P<0.05).CONCLUSION:The expression levels of Gas6,SDF-1α and SDF-1β genes in serum in patients with DR are elevated.They might be related to abnormal blood lipid metabolism and inflammatory response.%目的:探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者血清中生长停滞特异基因6(growth arrest specific gene 6,Gas6)、基质细胞衍生因子(stromal cell-derived factor-1,SDF-1)和SDF-1β表达的变化及临床意义.方法:DR患者113例分为增殖性组(n=45)和非增殖性组(n=68),同期选取未合并DR糖尿病患者作为糖尿病组(49例)和健康者42例,检测血糖、血脂和超敏C-反应蛋白(highly sensitive C-reactive protein,hs-CRP)指标,利用实时荧光定量PCR技术检测血清中Gas6、SDF-1α和SDF-1β基因表达.结果:糖尿病组、非增殖性组和增殖性组患者稳态模型的胰岛素抵抗指数(homeostasis model assessment for insulin resistance,HOMA-IR)、甘油三酯(triglycerides,TG)和hs-CRP均逐渐升高,差异均有统计学意义(F=39.672、81.625、99.872,均P<0.05),增殖性组和非增殖性组患者低密度脂蛋白(low-density lipoprotein,LDL-C)均高于糖尿病组和健康者,而高密度脂蛋白(high density lipoprotein,HDL-C)均低于糖尿病组和健康者,差异均有统计学意义(F=51.974、43.824,均P<0.05);增殖性组、非增殖性组和糖尿病组患者血清Gas6 mRNA表达量均高于健康者,增殖性组患者血清SDF-1α mRNA表达量均高于非增殖性组、糖尿病组和健康者,增殖性组和非增殖性组患者血清SDF-1β mRNA表达量均高于糖尿病组和健康者,且增殖性组患者高于非增殖组,差异均有统计学意义(F=15.381、21.589、38.942,P<0.05);Pearson相关分析显示,DR患者血清Gas6 mRNA表达量与TG、总胆固醇(total cholesterol,TC)和LDL-C呈正相关(r=0.228、0.241、0.209,均P<0.05),血清SDF-1α mRNA和SDF-1β mRNA表达量均与hs-CRP呈正相关(r=0.297、0.325,P<0.05).结论:DR患者血清中Gas6、SDF-1α和SDF-1β基因表达水平升高,可能与患者血脂代谢异常及炎性反应有关.