Department of Clinical Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, Jiangsu 224001, China.
Dis Markers. 2019 Mar 24;2019:9401628. doi: 10.1155/2019/9401628. eCollection 2019.
Investigations regarding serum and plasma vascular endothelial growth factor (VEGF) levels in patients with diabetic retinopathy (DR) are conflicting. This meta-analysis is aimed at determining whether serum and plasma VEGF levels are associated with DR and its severity in diabetic patients.
PubMed and EMBASE were used to search for published studies, and serum and plasma VEGF levels were compared among DR, nonproliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), and nondiabetic retinopathy (NDR) patients. Standardized mean differences (SMD) and 95% confidence interval (CI) were pooled using a random effects model.
A total of 29 studies comprising 1805 DR (or NPDR or PDR) patients and 1699 NDR patients were included. ELISA was used to evaluate serum or plasma VEGF levels in all except for two studies included in this meta-analysis. Overall, serum VEGF levels were significantly higher in DR patients (SMD: 0.74, 95% CI: 0.44-1.03) than those in NDR patients, while plasma VEGF levels were not in the comparison (SMD: 0.40, 95% CI: -0.13-0.92). Similarly, NPDR (SMD: 0.51, 95% CI: 0.22-0.80) and PDR (SMD: 1.32, 95% CI: 0.79-1.85) patients had higher serum VEGF levels compared with NDR patients, but the difference was not significant in plasma samples (SMD: 0.24, 95% CI: -0.47-0.95; SMD: 0.37, 95% CI: -0.30-1.05). In addition, serum VEGF levels were higher in PDR patients than those in NPDR patients (SMD: 0.87, 95% CI: 0.41-1.33), but plasma VEGF levels were not (SMD: -0.00, 95% CI: -0.31-0.31). The subgroup and metaregression analysis revealed that the study location, study design, and publication year of a study have certain influence on heterogeneity between studies in serum or plasma samples.
VEGF levels in the serum instead of those in the plasma correlate to the presence and severity of DR in diabetic patients. Further large-scale studies are required to confirm these findings.
关于糖尿病视网膜病变（DR）患者血清和血浆血管内皮生长因子（VEGF）水平的研究结果存在争议。本荟萃分析旨在确定血清和血浆 VEGF 水平是否与糖尿病患者的 DR 及其严重程度相关。
使用 PubMed 和 EMBASE 搜索已发表的研究，比较 DR、非增生性糖尿病视网膜病变（NPDR）、增生性糖尿病视网膜病变（PDR）和非糖尿病性视网膜病变（NDR）患者的血清和血浆 VEGF 水平。使用随机效应模型汇总标准化均数差（SMD）和 95%置信区间（CI）。
共纳入 29 项研究，包括 1805 例 DR（或 NPDR 或 PDR）患者和 1699 例 NDR 患者。除本荟萃分析中纳入的两项研究外，所有研究均采用 ELISA 法评估血清或血浆 VEGF 水平。总体而言，DR 患者的血清 VEGF 水平明显高于 NDR 患者（SMD：0.74，95%CI：0.44-1.03），而血浆 VEGF 水平在两组间无差异（SMD：0.40，95%CI：-0.13-0.92）。同样，NPDR（SMD：0.51，95%CI：0.22-0.80）和 PDR（SMD：1.32，95%CI：0.79-1.85）患者的血清 VEGF 水平也高于 NDR 患者，但在血浆样本中差异无统计学意义（SMD：0.24，95%CI：-0.47-0.95；SMD：0.37，95%CI：-0.30-1.05）。此外，PDR 患者的血清 VEGF 水平高于 NPDR 患者（SMD：0.87，95%CI：0.41-1.33），但血浆 VEGF 水平无差异（SMD：-0.00，95%CI：-0.31-0.31）。亚组和荟萃回归分析显示，研究地点、研究设计和研究发表年份对血清或血浆样本中研究间的异质性有一定影响。
血清 VEGF 水平而非血浆 VEGF 水平与糖尿病患者 DR 的发生和严重程度相关。需要进一步开展大规模研究来证实这些发现。
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