糖尿病视网膜病变患者亚临床甲状腺功能减退症：血管内皮生长因子的作用。

Subclinical Hypothyroidism in Patients with Diabetic Retinopathy: Role of Vascular Endothelial Growth Factor.

机构信息

Department of Internal Medicine, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Department of Ophthalmology, Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Endocr Metab Immune Disord Drug Targets. 2022;22(5):502-509. doi: 10.2174/1871530321666210809151258.

DOI:10.2174/1871530321666210809151258

PMID:34370652

Abstract

BACKGROUND

This study was conducted by considering the vital role of Vascular Endothelial Growth Factor (VEGF) in the development of Diabetic Retinopathy (DR) on the one hand and the frequent association between Subclinical Hypothyroidism (SCH) and DR on the other hand.

OBJECTIVE

The present study was proposed to explore the possible role of VEGF in the relation between SCH and DR; thus, we investigated the relationship between SCH and VEGF levels in patients with DR.

METHODS

Two hundred patients with DR were recruited in this study [100 patients with Proliferative Diabetic Retinopathy (PDR) and 100 patients with Non-Proliferative Diabetic Retinopathy (NPDR)]. Patients with DR were divided into 2 groups according to thyroid function, patients with SCH or those with euthyroidism. Patients were subjected to careful history taking and underwent clinical and ophthalmological examination. Fasting blood glucose, glycosylated hemoglobin, fasting insulin, Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), TSH, FT4, FT3, VEGF, and thyroid volume were assessed.

RESULTS

Among all the studied patients, 21.5% (43/200) had SCH. DR patients with SCH had older age, longer diabetes duration, and higher HbA1c, HOMA-IR, and VEGF than those with euthyroidism. The frequency of PDR in patients with SCH was 72.1% (31/43) and 43.9% (69/157) in those with euthyroidism, whereas the frequency of NPDR in patients with SCH was 27.9 (12/43) and 56.1% (88/157) in those with euthyroidism (P 0.003). In multivariate analysis, PDR, HOMA- IR, and VEGF levels were the significant predictor variables of SCH.

CONCLUSION

Increased VEGF levels may be implicated in the relationship between SCH and DR.

摘要

背景

本研究考虑到血管内皮生长因子（VEGF）在糖尿病视网膜病变（DR）发展中的重要作用，以及亚临床甲状腺功能减退症（SCH）与 DR 之间的频繁关联。

目的

本研究旨在探讨 VEGF 在 SCH 与 DR 之间的关系中的可能作用，因此，我们研究了 DR 患者中 SCH 和 VEGF 水平之间的关系。

方法

本研究纳入了 200 名 DR 患者[100 名增殖性糖尿病视网膜病变（PDR）患者和 100 名非增殖性糖尿病视网膜病变（NPDR）患者]。根据甲状腺功能将 DR 患者分为 2 组，SCH 患者或甲状腺功能正常患者。患者接受详细的病史采集，并进行临床和眼科检查。检测空腹血糖、糖化血红蛋白、空腹胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、促甲状腺激素（TSH）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）、VEGF 和甲状腺体积。

结果

在所有研究患者中，21.5%（43/200）有 SCH。SCH 的 DR 患者年龄较大，糖尿病病程较长，HbA1c、HOMA-IR 和 VEGF 水平较高。SCH 患者中 PDR 的发生率为 72.1%（31/43），甲状腺功能正常患者中为 43.9%（69/157），而 SCH 患者中 NPDR 的发生率为 27.9%（12/43），甲状腺功能正常患者中为 56.1%（88/157）（P<0.003）。多变量分析显示，PDR、HOMA-IR 和 VEGF 水平是 SCH 的显著预测变量。