Basaksehir Cam and Sakura City Hospital, Department of Ophthalmology, İstanbul, Turkey.
Yıldırım Beyazıt University, Department of Ophthalmology, Ankara, Turkey.
Indian J Ophthalmol. 2021 Nov;69(11):3376-3380. doi: 10.4103/ijo.IJO_3724_20.
To evaluate the aqueous and serum levels of sphingolipid metabolism mediators such as sphingosine 1 phosphate (S1P), sphingosine kinase 1 (SK1), sphingosine kinase 2 (SK2), ceramide kinase (CK), and acid sphingomyelinase (ASM) which are thought to take part in diabetic retinopathy (DR) pathogenesis, and development and severity of diabetic retinopathy (DR) in patients with type 2 diabetes.
A prospective cross-sectional study was conducted on type 2 diabetic and control patients who underwent cataract surgery. Three different subgroups, namely, non-diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR), were allocated and the S1P, SK1, SK2, CK, and ASM levels in the serum and aqueous humor samples of diabetic and control patients were evaluated. Kolmogorov-Smirnov test, Student's t-test, and Mann-Whitney U test were used for the statistical analysis of the study.
Among a total of 45 patients, including diabetic and control patients, the mean aqueous levels of SK1 (P < 0.001), SK2 (P = 0.012), ASM (P = 0.006), and CK (P = 0.002) were higher in all diabetic patients. The mean aqueous level of S1P was significantly higher in the PDR group than in other groups (P = 0.003). The mean aqueous levels of SK2 and ASM also increased in the NDR, NPDR, and PDR subgroups, respectively (P < 0.001). In addition, the mean serum levels of S1P, SK1, and ASM were higher in the diabetic patients (P = 0.015, P = 0.034, and P = 0.006, respectively).
According to our findings, both aqueous and serum levels of S1P, SK1, and ASM and only the aqueous levels of SK2 and CK were higher in diabetic patients. This study suggested that sphingolipid metabolism may play an important role in DR pathogenesis.
评估鞘脂代谢介质（如 1-磷酸鞘氨醇（S1P）、鞘氨醇激酶 1（SK1）、鞘氨醇激酶 2（SK2）、神经酰胺激酶（CK）和酸性鞘磷脂酶（ASM））的水相和血清水平，这些介质被认为参与了糖尿病视网膜病变（DR）的发病机制，以及 2 型糖尿病患者 DR 的发展和严重程度。
对接受白内障手术的 2 型糖尿病和对照患者进行了前瞻性横断面研究。将患者分为无糖尿病视网膜病变（NDR）、非增殖性糖尿病视网膜病变（NPDR）和增殖性糖尿病视网膜病变（PDR）三个不同亚组，并评估了糖尿病和对照组患者血清和房水样本中的 S1P、SK1、SK2、CK 和 ASM 水平。使用 Kolmogorov-Smirnov 检验、Student's t 检验和 Mann-Whitney U 检验对研究进行了统计分析。
在总共 45 名患者中，包括糖尿病患者和对照组患者，所有糖尿病患者的水相 SK1（P < 0.001）、SK2（P = 0.012）、ASM（P = 0.006）和 CK（P = 0.002）的平均水平均较高。PDR 组的 S1P 水相平均水平明显高于其他组（P = 0.003）。NDR、NPDR 和 PDR 亚组的 SK2 和 ASM 的水相平均水平也分别升高（P < 0.001）。此外，糖尿病患者的血清 S1P、SK1 和 ASM 平均水平较高（P = 0.015、P = 0.034 和 P = 0.006）。
根据我们的发现，糖尿病患者的水相和血清 S1P、SK1 和 ASM 水平以及仅水相 SK2 和 CK 水平较高。本研究表明，鞘脂代谢可能在 DR 的发病机制中起重要作用。
