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糖尿病视网膜病变中视网膜电图 b 波绝对潜伏期、人碱性成纤维细胞生长因子、血管内皮生长因子、可溶性脂肪酸合酶和肾上腺髓质素的血浆水平的相关性。

Correlation of electroretinography b-wave absolute latency, plasma levels of human basic fibroblast growth factor, vascular endothelial growth factor, soluble fatty acid synthase, and adrenomedullin in diabetic retinopathy.

机构信息

Clinical Physiology Department, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

J Diabetes Complications. 2010 May-Jun;24(3):179-85. doi: 10.1016/j.jdiacomp.2008.12.007. Epub 2009 Feb 12.

Abstract

BACKGROUND

We investigated the b-wave latency of electroretinogram (ERG), human basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), soluble fatty acid synthase (s-Fas), and adrenomedullin (ADM) in diabetic retinopathy.

PATIENTS AND METHODS

Thirty control and 60 type II diabetic women (mean age 45+/-3.9 years, duration of diabetes 10.1+/-2.1 years) were investigated. Diabetics without complications (Group II) and with retinopathy (Group III) were diagnosed depending on clinical findings, abnormal fundus examination, and ERG. Plasma levels of b-FGF, VEGF, s-Fas, and ADM were measured.

RESULTS

ERG showed a significant increase of b-wave absolute latency, plasma b-FGF, VEGF, s-Fas, and ADM in diabetic retinopathy (P<.05). A positive correlation was found between b-wave latency and VEGF and s-Fas, and a negative correlation with b-FGF and ADM.

CONCLUSION

This study elucidates the causative role of VEGF and s-Fas in diabetic retinopathy. VEGF may potently promote growth of endothelial cells and formation of new vessels implicated in proliferative retinopathy. s-Fas could be involved in advancement of apoptotic changes in retinopathy and high levels of b-FGF, and ADM may be compensatorily neuroprotective and vasculoprotective. The results showed that diabetic retinopathy is the result of multiple factors, so it is optimistic to believe that reversing VEGF or s-Fas will halt retinopathy, targeting multiple mechanisms simultaneously by administering combination treatments of VEGF antagonists; antiapoptotic drugs together with b-FGF and/or ADM may be prospective.

摘要

背景

我们研究了电视网膜图(ERG)、人碱性成纤维细胞生长因子(b-FGF)、血管内皮生长因子(VEGF)、可溶性脂肪酸合酶(s-Fas)和肾上腺髓质素(ADM)在糖尿病视网膜病变中的 b 波潜伏期。

患者和方法

研究了 30 名对照和 60 名 2 型糖尿病女性(平均年龄 45+/-3.9 岁,糖尿病病程 10.1+/-2.1 年)。根据临床发现、异常眼底检查和 ERG,将无并发症的糖尿病患者(第 II 组)和有视网膜病变的糖尿病患者(第 III 组)诊断为糖尿病。测量血浆 b-FGF、VEGF、s-Fas 和 ADM 水平。

结果

ERG 显示 b 波绝对潜伏期、血浆 b-FGF、VEGF、s-Fas 和 ADM 在糖尿病视网膜病变中显著增加(P<.05)。b 波潜伏期与 VEGF 和 s-Fas 呈正相关,与 b-FGF 和 ADM 呈负相关。

结论

本研究阐明了 VEGF 和 s-Fas 在糖尿病视网膜病变中的致病作用。VEGF 可能强力促进内皮细胞的生长和新血管的形成,从而参与增生性视网膜病变。s-Fas 可能参与视网膜病变中凋亡变化的进展,以及 b-FGF 和 ADM 水平的升高可能具有神经保护和血管保护作用。研究结果表明,糖尿病视网膜病变是多种因素的结果,因此乐观地认为,通过同时靶向多种机制,用 VEGF 拮抗剂逆转 VEGF 或 s-Fas 将阻止视网膜病变的进展,联合使用 VEGF 拮抗剂、抗凋亡药物以及 b-FGF 和/或 ADM 的组合治疗可能具有前景。

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