Matsuyama Kayako, Ogata Nahoko, Matsuoka Masato, Shima Chieko, Wada Mitsumasa, Jo Nobuo, Matsumura Miyo
Department of Ophthalmology, Kansai Medical University, Moriguchi, Osaka, Japan.
Mol Vis. 2008 May 28;14:992-6.
Diabetic retinopathy and nephropathy are microvascular complications in patients with diabetes that are considered to be related. Pigment epithelium-derived factor (PEDF), a strong inhibitor of angiogenesis, is significantly elevated in the blood of diabetic patients, especially those with proliferative diabetic retinopathy (PDR). The level of PEDF in the blood, on the other hand, is reported to be low in a diabetic nephropathy. The aim of this study was to determine the relationship between PEDF and renal function in patients with diabetic retinopathy.
A total of 243 type 2 diabetic patients were studied. The relationship between the diabetic retinopathy and levels of PEDF, HbA1c, blood urea nitrogen (BUN), and creatinine were evaluated.
The mean plasma PEDF level in patients with PDR (7.69+/-6.14 microg/ml; mean+/-standard error) was significantly higher than that of mild-to-moderate nonproliferative diabetic retinopathy (5.07+/-4.37 microg/ml, p=0.02). The level of BUN and creatinine increased significantly as the stage of diabetic retinopathy advanced. The plasma PEDF levels were significantly correlated with the levels of BUN and creatinine (r=0.54, p<0.0001; r=0.57, p<0.0001, respectively).
The levels of plasma PEDF increases with advances in both diabetic retinopathy and nephropathy. Thus, increased levels of PEDF in the blood may indicate microvascular damages in diabetic patients and may be predictor of the progression of retinopathy and nephropathy.
糖尿病视网膜病变和肾病是糖尿病患者的微血管并发症，被认为彼此相关。色素上皮衍生因子（PEDF）是一种强大的血管生成抑制剂，在糖尿病患者血液中显著升高，尤其是增殖性糖尿病视网膜病变（PDR）患者。另一方面，据报道糖尿病肾病患者血液中的PEDF水平较低。本研究旨在确定糖尿病视网膜病变患者中PEDF与肾功能之间的关系。
共研究了243例2型糖尿病患者。评估了糖尿病视网膜病变与PEDF水平、糖化血红蛋白（HbA1c）、血尿素氮（BUN）和肌酐之间的关系。
PDR患者的平均血浆PEDF水平（7.69±6.14微克/毫升；平均值±标准误）显著高于轻度至中度非增殖性糖尿病视网膜病变患者（5.07±4.37微克/毫升，p = 0.02）。随着糖尿病视网膜病变阶段的进展，BUN和肌酐水平显著升高。血浆PEDF水平与BUN和肌酐水平显著相关（分别为r = 0.54，p < 0.0001；r = 0.57，p < 0.0001）。
血浆PEDF水平随着糖尿病视网膜病变和肾病的进展而升高。因此，血液中PEDF水平升高可能表明糖尿病患者存在微血管损伤，并且可能是视网膜病变和肾病进展的预测指标。
