Department of Medicine, Baruch Padeh Poria Medical Center, Faculty of Medicine in the Galilee Bar Ilan University, Galilee 15208, Israel.
Vascular Biology Research Laboratory, Baruch Padeh Poria Medical Center, Faculty of Medicine in the Galilee Bar Ilan University, Galilee 15208, Israel.
Cytokine. 2018 Jun;106:76-79. doi: 10.1016/j.cyto.2017.10.014. Epub 2017 Nov 11.
Proliferative diabetic retinopathy is a devastating complication of diabetes mellitus, developing within 15 years in 50% of patients with type 1 diabetes mellitus (DM) and in 10% of patients with type 2 DM. The correlation between levels of inflammatory markers in the peripheral blood and retinopathy staging has not been studied yet, and the purpose of this prospective study was to find a possible association between inflammation and staging of diabetic retinopathy.
A prospective (pilot) study that measured level of adhesion molecules in the peripheral blood of 10 healthy subjects and 30 patients with type 2 diabetes mellitus. Patients were grouped by the degree of retinopathy: 10 without retinopathy, 10 with non-proliferative retinopathy [NPDR] and 10 with proliferative retinopathy [PDR]. After signing the consent form, an ophthalmologic examination was performed, and 10 mL of blood was drawn. In order to assess adhesion molecules' level serum samples were collected, frozen, and stored at a temperature of -80 °C until analysis was performed as one batch.
10 healthy volunteers and 30 patients were enrolled. Healthy volunteers were younger (36.6 ± 7.9 years) compared to patients (no retinopathy 64.5 ± 10.8 years, NPDR 71.4 ± 8.9 years, and PDR 63.3 ± 11.6 years) (p = .0003 for all groups of patients in comparison with the healthy subjects). VCAM-1 levels were increased by retinopathy staging - starting from 81.86 ± 3.80 ng/ml (healthy), 105.55 ± 1.37 ng/ml (no retinopathy), 111.78 ± 4.14 ng/ml (NPDR), and 123.45 ± 3.99 ng/ml (PDR), with a significant difference between healthy and patients without retinopathy (p = .03), between no retinopathy and NPDR (p = .001), and between NPDR and PDR (p < .0001). E selectin was increased in correlation with severity of the retinopathy, with a significant difference between groups of patients (p = .03 between healthy subjects and T2DM patients without retinopathy, p = .001 between patients with T2DM no retinopathy and NPDR, p < .0001 between NPDR and PDR).
We found a significant increase in levels of adhesion molecules (VCAM-1) and selectins (E-selectin) in parallel with increased severity of diabetic retinopathy, with a significant difference of inflammatory markers between stages of retinopathy.
增生性糖尿病视网膜病变是糖尿病的一种严重并发症，在 15 年内，50%的 1 型糖尿病（DM）患者和 10%的 2 型 DM 患者会出现这种病变。外周血中炎症标志物水平与视网膜病变分期之间的相关性尚未得到研究，本前瞻性研究的目的是寻找炎症与糖尿病视网膜病变分期之间的可能联系。
这是一项前瞻性（初步）研究，测量了 10 名健康受试者和 30 名 2 型糖尿病患者外周血中黏附分子的水平。根据视网膜病变的程度将患者分为三组：10 名无视网膜病变患者、10 名非增生性视网膜病变（NPDR）患者和 10 名增生性视网膜病变（PDR）患者。在签署同意书后，对患者进行眼科检查，并抽取 10ml 血液。为了评估黏附分子的水平，采集血清样本，冷冻并储存在-80°C 的温度下，直到作为一批进行分析。
共纳入 10 名健康志愿者和 30 名患者。健康志愿者比患者年轻（36.6±7.9 岁比 64.5±10.8 岁、71.4±8.9 岁和 63.3±11.6 岁）（所有患者组与健康受试者相比，p 值均为<.0003）。VCAM-1 水平随着视网膜病变的分期而升高-从 81.86±3.80ng/ml（健康）、105.55±1.37ng/ml（无视网膜病变）、111.78±4.14ng/ml（NPDR）和 123.45±3.99ng/ml（PDR），健康组与无视网膜病变组之间有显著差异（p=.03），无视网膜病变组与 NPDR 组之间有显著差异（p=.001），NPDR 组与 PDR 组之间有显著差异（p<.0001）。E 选择素与视网膜病变的严重程度呈正相关，各组患者之间有显著差异（p=.03 健康组与无糖尿病视网膜病变的 2 型糖尿病患者，p=.001 无糖尿病视网膜病变的 2 型糖尿病患者与 NPDR，p<.0001 NPDR 与 PDR）。
我们发现，随着糖尿病视网膜病变的严重程度增加，黏附分子（VCAM-1）和选择素（E-选择素）的水平显著升高，并且在视网膜病变的各个阶段之间，炎症标志物的差异具有统计学意义。
