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：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.