Kwong-Han Kiu, Zunaina Embong, Hanizasurana Hashim, Che-Badariah Abd Aziz, Che-Maraina Che Hussin
Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab II, 16150 Kubang Kerian, Kelantan, Malaysia.
J Diabetes Metab Disord. 2022 Mar 19;21(1):681-688. doi: 10.1007/s40200-022-01030-2. eCollection 2022 Jun.
Various studies suggest that oxidative stress has a role in the etiology of diabetes mellitus (DM) and its complications. Detection of antioxidant enzymes and malondialdehyde (MDA) level in ocular fluid may provide the possible biomarkers for monitoring the progression of diabetic retinopathy (DR). The aim of this study was to compare catalase, glutathione peroxidase (GPx) and MDA levels in tears among diabetic patients with and without DR.
A cross-sectional study was conducted among type 2 DM patients. The patients were divided into three groups: no DR, non-proliferative DR (NPDR) and proliferative DR (PDR). Tears samples were collected using Schirmer strips for measurement of catalase, GPx and MDA.
A total of 171 patients were recruited in this study (no DR, 58 patients; NPDR, 57 patients; PDR, 56 patients). There was significant difference in the mean level of GPx in tears between the three groups (no DR, 658.08 ± 115.70 U/L; NPDR, 653.78 ± 87.90 U/L; PDR, 605.31 ± 107.47 U/L, respectively) before and after adjustment for covariates ( = 0.013 and = 0.001, respectively). Bonferroni post-hoc analysis showed PDR group had significantly lower mean GPx level than in no DR (=0.001) and NPDR (=0.037) after adjustment for covariates. There was no significant difference of mean catalase and MDA in the tears between the three groups before and after adjustment for covariates.
This study demonstrated that diabetic patient with DR is associated with low level of GPx in tears, suggesting that this antioxidant enzyme is a potential biomarker for predicting the presence of DR.
多项研究表明，氧化应激在糖尿病及其并发症的病因学中起作用。检测眼液中的抗氧化酶和丙二醛（MDA）水平可能为监测糖尿病视网膜病变（DR）的进展提供潜在的生物标志物。本研究的目的是比较有和没有DR的糖尿病患者泪液中过氧化氢酶、谷胱甘肽过氧化物酶（GPx）和MDA的水平。
对2型糖尿病患者进行横断面研究。患者分为三组：无DR组、非增殖性DR（NPDR）组和增殖性DR（PDR）组。使用泪液试纸收集泪液样本，以测量过氧化氢酶、GPx和MDA。
本研究共纳入171例患者（无DR组58例；NPDR组57例；PDR组56例）。在调整协变量前后，三组泪液中GPx的平均水平存在显著差异（无DR组分别为658.08±115.70 U/L；NPDR组为653.78±87.90 U/L；PDR组为605.31±107.47 U/L，分别为=0.013和=0.001）。Bonferroni事后分析显示，在调整协变量后，PDR组的平均GPx水平显著低于无DR组（=0.001）和NPDR组（=0.037）。在调整协变量前后，三组泪液中过氧化氢酶和MDA的平均水平无显著差异。
本研究表明，患有DR的糖尿病患者泪液中GPx水平较低，提示这种抗氧化酶是预测DR存在的潜在生物标志物。
