Department of Biochemistry, Dr. B. C. Roy Post Graduate Institute of Basic Medical Education and Research, IPGMER and SSKM Hospital, Kolkata, India.
Retina. 2013 Jan;33(1):207-16. doi: 10.1097/IAE.0b013e318256202e.
To evaluate erythrocyte redox state and its surrogates in patients with different stages of diabetic retinopathy and their association with cellular metabolic derangement developed in retinal microvascular cells.
Sixty type 2 diabetic patients with nonproliferative diabetic retinopathy (NPDR), 85 patients with proliferative diabetic retinopathy (PDR), and 70 patients with diabetes but without retinopathy were considered as diabetic control (DC) for the study. In addition, 65 normal individuals without diabetes were enrolled as healthy control in this study. Erythrocyte oxidized nicotinamide adenine dinucleotide phosphate / reduced nicotinamide adenine dinucleotide phosphate (NADP / NADPH), oxidized nicotinamide adenine dinucleotide / reduced nicotinamide adenine dinucleotide (NAD / NADH) glutathione, plasma and vitreous lactate, and pyruvate levels were determined by enzymatic reaction-based spectrophotometric assay for the patients and individuals.
Erythrocyte NADP+ to NADPH ratio to NADPH ratio was found to be significantly higher among NPDR and PDR patients compared with DC subjects (P < 0.0001). Erythrocyte-reduced glutathione was significantly decreased in patients of NPDR (P = 0.0004) and patients of PDR (P = 0.0157) compared to DC. Erythrocyte NAD to NADH ratio was also significantly decreased in patients of NPDR (P < 0.0001) and PDR (P < 0.0001) compared to DC subjects. Lactate to pyruvate ratio of plasma was elevated significantly in patients with NPDR compared with DC (P < 0.0001) and those having PDR (P = 0.0046). In the vitreous fluid, the lactate to pyruvate ratios were found to be significantly lower in normal individuals without diabetes compared with patients having PDR (P < 0.0001).
Hyperglycemia-mediated erythrocyte redox state alterations might be a potential risk factor for the development of NPDR in poorly controlled diabetic subjects.
评估不同阶段糖尿病视网膜病变患者的红细胞氧化还原状态及其替代物，并研究其与视网膜微血管细胞代谢紊乱的关系。
将 60 例非增殖性糖尿病视网膜病变（NPDR）、85 例增殖性糖尿病视网膜病变（PDR）和 70 例糖尿病但无视网膜病变的患者作为糖尿病对照组（DC）纳入研究。此外，65 例无糖尿病的正常人作为健康对照组纳入本研究。采用基于酶反应的分光光度法测定患者和个体的红细胞氧化型烟酰胺腺嘌呤二核苷酸磷酸/还原型烟酰胺腺嘌呤二核苷酸磷酸（NADP/NADPH）、氧化型烟酰胺腺嘌呤二核苷酸/还原型烟酰胺腺嘌呤二核苷酸（NAD/NADH）、谷胱甘肽、血浆和玻璃体液中乳酸和丙酮酸的水平。
与 DC 组相比，NPDR 和 PDR 患者的红细胞 NADP+/NADPH 比值明显升高（P<0.0001）。与 DC 组相比，NPDR 患者（P=0.0004）和 PDR 患者（P=0.0157）的红细胞还原型谷胱甘肽明显减少。与 DC 组相比，NPDR 患者（P<0.0001）和 PDR 患者（P<0.0001）的红细胞 NAD/NADH 比值也明显降低。与 DC 组相比，NPDR 患者的血浆乳酸/丙酮酸比值显著升高（P<0.0001），PDR 患者（P=0.0046）也有升高。在玻璃体液中，与 PDR 患者相比，无糖尿病个体的乳酸/丙酮酸比值明显较低（P<0.0001）。
高血糖介导的红细胞氧化还原状态改变可能是血糖控制不佳的糖尿病患者发生 NPDR 的潜在危险因素。
