Ju Hai-Bing, Zhang Fu-Xian, Wang Shuang, Song Jie, Cui Tao, Li Li-Feng, Zhang Hai-Yan
Department of Endocrinology, Kunming General Hospital of Chengdu Military Area Command, Kunming, China.
Medicine (Baltimore). 2017 Aug;96(31):e7671. doi: 10.1097/MD.0000000000007671.
The role of cytokines in diabetic retinopathy (DR) and effects of fenofibrate on cytokines were explored by observing changes in serum IL-1β, TNF-α, VEGF, and Lp-PLA2 in different stages of DR and the intervention effect of oral fenofibrate on cytokines.In total, 190 patients with type 2 DR were enrolled and divided into 3 groups: diabetic without retinopathy (NDR) group (n = 30), nonproliferative diabetic retinopathy (NPDR) group (n = 80), and proliferative diabetic retinopathy (PDR) group (n = 80). According to whether or not to accept fenofibrate treatment, NPDR and PDR groups were further divided into the NPDR control (NPDR1) group (n = 40) and the NPDR treatment (NPDR2) group (n = 40), and the proliferative diabetic retinopathy control (PDR1, n = 40) group and the proliferative diabetic retinopathy treatment (PDR2) group (n = 40). At 12 weeks after fenofibrate treatment, serum IL-1β, TNF-α, VEGF, and Lp-PLA2 levels were detected.In PDR and NPDR patients, levels of serum cytokines such as IL-1β (120.56 ± 27.32 pg/mL vs 112.34 ± 19.45 pg/mL vs 82.9 ± 13.8 pg/mL), TNF-α (125.86 ± 25.57 pg/mL vs 109.48 ± 20.15 pg/mL vs 80.7 ± 12.8 pg/mL), VEGF (166.65 ± 37.74 pg/mL vs 148.54 ± 36.27 pg/mL vs 88.97 ± 24.86 pg/mL), and Lp-PLA2 (172.34 ± 45.22 μg/L vs 154.66 ± 40.98 μg/L vs 125.88 ± 38.87 μg/L) were significantly higher than in diabetes patients without retinopathy. After fenofibrate treatment, serum IL-1β, TNF-α, VEGF, and Lp-PLA2 significantly decreased in NPDR and PDR patients.Serum IL-1β, TNF-α, VEGF, and Lp-PLA2 play an important role in occurrence and development of diabetic retinopathy. Fenofibrate can reduce cytokine levels in DR patients and improve inflammatory response.
通过观察糖尿病视网膜病变（DR）不同阶段血清白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、血管内皮生长因子（VEGF）和脂蛋白磷脂酶A2（Lp-PLA2）的变化以及口服非诺贝特对细胞因子的干预作用，探讨细胞因子在DR中的作用及非诺贝特对细胞因子的影响。共纳入190例2型DR患者，分为3组：无糖尿病视网膜病变（NDR）组（n = 30）、非增殖性糖尿病视网膜病变（NPDR）组（n = 80）和增殖性糖尿病视网膜病变（PDR）组（n = 80）。根据是否接受非诺贝特治疗，NPDR组和PDR组进一步分为NPDR对照组（NPDR1组，n = 40）和NPDR治疗组（NPDR2组，n = 40），以及增殖性糖尿病视网膜病变对照组（PDR1组，n = 40）和增殖性糖尿病视网膜病变治疗组（PDR2组，n = 40）。非诺贝特治疗12周后，检测血清IL-1β、TNF-α、VEGF和Lp-PLA2水平。在PDR和NPDR患者中，血清细胞因子如IL-1β（120.56±27.32 pg/mL vs 112.34±19.45 pg/mL vs 82.9±13.8 pg/mL）、TNF-α（125.86±25.57 pg/mL vs 109.48±20.15 pg/mL vs 80.7±12.8 pg/mL）、VEGF（166.65±37.74 pg/mL vs 148.54±36.27 pg/mL vs 88.97±24.86 pg/mL）和Lp-PLA2（172.34±45.22 μg/L vs 154.66±40.98 μg/L vs 125.88±38.87 μg/L）水平显著高于无糖尿病视网膜病变的糖尿病患者。非诺贝特治疗后，NPDR和PDR患者血清IL-1β、TNF-α、VEGF和Lp-PLA2显著降低。血清IL-1β、TNF-α、VEGF和Lp-PLA2在糖尿病视网膜病变的发生和发展中起重要作用。非诺贝特可降低DR患者的细胞因子水平并改善炎症反应。
