高血浆不对称二甲基精氨酸水平导致脉络膜厚度减少与糖尿病视网膜病变严重程度增加之间的关系。
The relationship between reduced choroidal thickness due to high plasma asymmetrical dimethylarginine level and increased severity of diabetic retinopathy.
机构信息
Department of Ophthalmology, University of Health Sciences Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
出版信息
Arq Bras Oftalmol. 2023 Jan-Feb;86(1):27-32. doi: 10.5935/0004-2749.20230007.
PURPOSE
To evaluate the relationship between subfoveal choroidal thickness and plasma asymmetrical dimethylarginine level and the severity of diabetic retinopathy in patients with type 2 diabetes mellitus.
METHODS
A total of 68 cases, including 15 patients without diabetic retinopathy, 17 patients with nonproliferative diabetic retinopathy, 16 patients with type 2 diabetes mellitus and proliferative diabetic retinopathy, and 20 healthy patients (control group), were enrolled in this study. Subfoveal choroidal thickness was measured manually using the enhanced depth imaging optical coherence tomography scanning program, and plasma asymmetrical dimethylarginine level was measured using a commercial micro enzyme-linked immunosorbent assay kit.
RESULTS
The subfoveal choroidal thickness values and plasma asymmetrical dimethylarginine levels were significantly different between the four groups (p<0.001 and p<0.001). The subfoveal choroidal thickness values were significantly lower in the proliferative diabetic retinopathy group than in the other three groups (no diabetic retinopathy, nonproliferative diabetic retinopathy, and control groups; p<0.001, p=0.045, and p<0.001, respectively). The plasma asymmetrical dimethylarginine levels were significantly higher in the proliferative diabetic retinopathy group than in the other three groups (p<0.001, p<0.04, and p<0.001, respectively). In addition, a significant negative correlation was also found between plasma asymmetrical dimethylarginine level and subfoveal choroidal thickness (p<0.001, r=-0.479).
CONCLUSION
Asymmetrical dimethylarginine is an important marker of endothelial dysfunction and endogenous endothelial nitric oxide synthase inhibitor. The severity of diabetic retinopathy was related to increased plasma asymmetrical dimethylarginine level and reduced subfoveal choroidal thickness in type 2 diabetic patients with diabetic retinopathy.
目的
评估 2 型糖尿病患者黄斑中心凹下脉络膜厚度与血浆非对称二甲基精氨酸水平及糖尿病视网膜病变严重程度的关系。
方法
共纳入 68 例患者，其中无糖尿病视网膜病变 15 例，非增生型糖尿病视网膜病变 17 例，增生型糖尿病视网膜病变 16 例，健康对照 20 例。应用增强深度成像光学相干断层扫描程序手动测量黄斑中心凹下脉络膜厚度，采用商用微酶联免疫吸附试验试剂盒检测血浆非对称二甲基精氨酸水平。
结果
四组间黄斑中心凹下脉络膜厚度值和血浆非对称二甲基精氨酸水平差异均有统计学意义（p<0.001 和 p<0.001）。与其他三组相比，增生型糖尿病视网膜病变组黄斑中心凹下脉络膜厚度值明显降低（无糖尿病视网膜病变组、非增生型糖尿病视网膜病变组和对照组；p<0.001、p=0.045 和 p<0.001）。与其他三组相比，增生型糖尿病视网膜病变组血浆非对称二甲基精氨酸水平明显升高（p<0.001、p<0.04 和 p<0.001）。此外，还发现血浆非对称二甲基精氨酸水平与黄斑中心凹下脉络膜厚度呈显著负相关（p<0.001，r=-0.479）。
结论
非对称二甲基精氨酸是内皮功能障碍和内源性内皮型一氧化氮合酶抑制剂的重要标志物。在合并糖尿病视网膜病变的 2 型糖尿病患者中，糖尿病视网膜病变的严重程度与血浆非对称二甲基精氨酸水平升高和黄斑中心凹下脉络膜厚度降低有关。
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