Pavlovschi Ecaterina, Pantea Valeriana, Borovic Djina, Tagadiuc Olga
Department of Biochemistry and Clinical Biochemistry, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova.
Laboratory of Biochemistry, Nicolae Testemitanu State University of Medicine and Pharmacy, Republic of Moldova.
Med Pharm Rep. 2021 Apr;94(2):185-190. doi: 10.15386/mpr-1815. Epub 2021 Apr 29.
Hypertension (HTN) is one of the leading causes of morbidity and mortality worldwide. A prompt diagnosis and treatment of hypertensive retinopathy (HR), the leading complication of HTN is pivotal for a better visual outcome. Increased blood pressure on its own cannot fully clarify the development of retinal alterations, therefore an additional pathogenetic mechanism, such as oxidative stress, might be inquired. of the study was to evaluate the changes in the level of ischemia modified albumin (IMA) in the serum and tears of HR patients in order to establish the predictive value of IMA for the HR progression.
Serum and tear samples for the measurement of IMA were collected from 90 patients detected primarily with HR, who were not taking any antihypertensive or other drug that could influence the results of the study, divided according to the Keith-Wagener classification into GI - 36 patients with HR grade I, GII - 35 with HR grade II and GIII - 19 with HR grade III. Serum and tear IMA levels were assessed using the Co binding method and expressed as median and interquartile range. Kruskal-Wallis and Mann-Whitney nonparametric tests were used to compare the groups and the Spearman correlation coefficient was calculated (SPSS 23.0), with p<0.05 being statistically significant.
The groups showed a statistically significant difference in serum IMA (p=0.006), the values increasing in parallel with the progression of HR. The serum IMA level in GII increased compared to GI (+3%; 239.06 μM/L (IQR 75.58) 231.77 μM/L (IQR 104.09), p=1.00), as well as in GIII patients compared to GII (+17%; 277.67 μM/L (IQR 88.72) 239.06 μM/L (IQR 75.58), p=0.04). There were no differences in IMA content (p=0.160), between groups in the tears. No correlations were found between serum and tear IMA levels (p=0.134), but serum IMA showed a significant moderate strength, positive correlation with the degree of HR (r=0.307, p=0.003).
A progressive enhancement in serum IMA level as HR advanced was identified. Thereby, the results suggest the potential relevance of serum IMA as a sensitive and early biomarker useful for grading and optimal treatment of the patients with HR.
高血压（HTN）是全球发病和死亡的主要原因之一。及时诊断和治疗高血压性视网膜病变（HR）这一HTN的主要并发症对于获得更好的视力结果至关重要。血压升高本身并不能完全阐明视网膜病变的发展，因此可能需要探究其他致病机制，如氧化应激。本研究旨在评估HR患者血清和泪液中缺血修饰白蛋白（IMA）水平的变化，以确定IMA对HR进展的预测价值。
从90例初诊为HR的患者中采集用于测量IMA的血清和泪液样本，这些患者未服用任何可能影响研究结果的抗高血压药物或其他药物，根据Keith-Wagener分类法分为GI组 - 36例HR I级患者、GII组 - 35例HR II级患者和GIII组 - 19例HR III级患者。采用钴结合法评估血清和泪液IMA水平，并以中位数和四分位数间距表示。使用Kruskal-Wallis和Mann-Whitney非参数检验比较各组，并计算Spearman相关系数（SPSS 23.0），p<0.05具有统计学意义。
各组血清IMA存在统计学显著差异（p=0.006），其值随HR进展而升高。与GI组相比，GII组血清IMA水平升高（+3%；239.06 μM/L（四分位数间距75.58）对231.77 μM/L（四分位数间距104.09），p=1.00），与GII组相比，GIII组患者血清IMA水平也升高（+17%；277.67 μM/L（四分位数间距88.72）对239.06 μM/L（四分位数间距75.58），p=0.04）。各组泪液中IMA含量无差异（p=0.160）。血清和泪液IMA水平之间未发现相关性（p=0.134），但血清IMA与HR程度呈显著中度正相关（r=0.307，p=0.003）。
随着HR进展，血清IMA水平逐渐升高。因此，结果表明血清IMA作为一种敏感的早期生物标志物，对于HR患者的分级和优化治疗具有潜在相关性。
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