2020 年第 3 期 第 15 卷

血清Chemerin评估糖尿病视网膜病变患者病情变化研究

Serum Chemerin in assessment of diabetic retinopathy progression

作者：孙文任韩

英文作者：

单位：海南省中医院眼科中心，海口570000

英文单位：

关键词：糖尿病视网膜病变；血清Chemerin；病情预测

英文关键词：

• 摘要：

• 【摘要】目的    探讨分析血清Chemerin水平评估糖尿病视网膜病变患者病情变化的价值。方法    选择2014年6月至2017年9月来海南省中医院就诊的2型糖尿病视网膜病变患者183例，其中单纯型糖尿病视网膜病变（SDR）85例为SDR组，增生型糖尿病视网膜病变（PDR）98例为PDR组，再选择同期收治的2型糖尿病无视网膜病变（NDR）患者50例作为NDR组。检测并比较3组患者血糖、糖化血红蛋白（HbA1c）、总胆固醇、三酰甘油、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、血清Chemerin及肿瘤坏死因子α（TNF-α）水平，分析各指标与血清Chemerin相关性，并采用受试者工作特征（ROC）曲线分析血清Chemerin水平对糖尿病视网膜病变患者病情的预测价值。结果    PDR组患者HbA1c、三酰甘油、总胆固醇、LDL-C水平高于NDR组与SDR组，SDR组患者HbA1c、三酰甘油、总胆固醇、LDL-C水平高于NDR组（均P＜0.05）；PDR组患者HDL-C水平低于NDR组与SDR组，SDR组患者HDL-C水平低于NDR组（均P＜0.05）。PDR组患者病程长于、血清Chemerin和TNF-α水平高于SDR组与NDR组［（10.9±2.7）年比（7.8±2.1）、（3.2±1.0）年；（44±6）μg/L比（35±5）、（28±6）μg/L；（43±8）ng/L比（32±5）、（15±4）ng/L］（均P＜0.05），且SDR组患者病程、血清Chemerin和TNF-α水平高于NDR组（均P＜0.05）。采用ROC曲线分析糖尿病视网膜病变患者血清Chemerin水平对病情预测价值，ROC曲线下面积为0.891。结论    糖尿病视网膜病变患者血清Chemerin水平升高，且与患者糖脂代谢异常有关，血清Chemerin可作为糖尿病视网膜病变患者病情进展的预测指标。

  
  

• 【Abstract】Objective    To investigate the value of serum Chemerin level in assessing the disease progression of diabetic retinopathy（DR）. Methods    Totally 183 type 2 diabetic patients with DR admitted to Chinese Medicine Hospital of Hainan Province from June 2014 to September 2017 were enrolled. According to clinical staging criteria, 85 patients had simple DR(SDR group) and 98 patients had proliferative DR(PDR group). Fifty type 2 diabetic patients without retinopathy were enrolled as NDR group. Blood glucose, glycated hemoglobin(HbA1c), total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), serum Chemerin and tumor necrosis factor-α(TNF-α) were detected. Correlations between serum Chemerin level and above indexes were analyzed. Predictive value of serum Chemerin level for DR progression was analyzed by receiver operating characteristic（ROC） curve. Results    Serum levels of HbA1c, TG, TC and LDL-C in the PDR group were higher than those in the NDR and SDR groups; serum levels of HbA1c, TG, TC and LDL-C in the SDR group were higher than those in the NDR group(all P＜0.05). Serum HDL-C level in the PDR group was lower than that in the NDR and SDR groups; serum HDL-C level in the SDR group was lower than that in the NDR group(all P＜0.05). Patients in the PDR group had longer course of disease, higher levels of serum Chemerin and TNF-α［(10.9±2.7)years vs (7.8±2.1),(3.2±1.0)years; (44±6)μg/L vs (35±5),(28±6)μg/L; (43±8)ng/L vs (32±5),(15±4)ng/L］ compared with the SDR and NDR groups(all P＜0.05); course of disease, serum Chemerin and TNF-α levels in the SDR group were longer/higher than those in the NDR group(all P＜0.05). ROC curve analysis showed a high predictive value of serum Chemerin in assessing DR progression（area under curve=0.891）. Conclusions    DR patients have elevated level of serum Chemerin, which is associated with abnormal glucose and lipid metabolism. Serum Chemerin level is a predictor of DR progression.