Mondal Lakshmi Kanta, Pramanik Subhasish, Chowdhury Subhankar, Bose Chiranjit, Bera Debgopal, Saha Ayindrila, Bhattacharjee Koena
Department of Ophthalmology, Regional Institute of Ophthalmology, Medical College Campus, Kolkata, 700 073, West Bengal, India.
Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, 700020, West Bengal, India.
Int J Retina Vitreous. 2022 Jun 11;8(1):39. doi: 10.1186/s40942-022-00390-4.
To assess the association of lipid and lipid-derived toxic molecules in pathogenesis and severity of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM).
The present cross-sectional study included 14 healthy individuals (HC) without T2DM, 22 T2DM subjects without DR (DNR), 24 T2DM subjects with mild non-proliferative DR (MNPDR), and 24 T2DM subjects with high-risk proliferative DR (HRPDR). All subjects underwent plasma and vitreous analysis for estimation of total lipid (TL), free fatty acid (FFA), lipid peroxides (LPOs) like malondialdehyde (MDA), 4-Hydroxy-noneal (HNE), the advanced lipoxidation end product (ALE) like Hexanoyl-lysine (HLY) and vascular endothelial growth factor (VEGF) following standard spectrophotometric and enzyme-linked immunosorbent assay (ELISA) methods respectively.
The concentration of TL, FFA, markers of lipid peroxidation and lipoxidation as well as VEGF in plasma and vitreous were found to be significantly elevated stepwise inT2DM subjects (HRPDR > MNPDR > DNR) compared to healthy controls (HC).Further, plasma conventional lipid components like total cholesterol (TCH), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG), FFA and TL showed their significant positive correlations with vitreous level of different LPOs, ALE and VEGF in the DR group.
Total lipid and lipid-derived detrimental biomolecules ultimately result in increased secretion of VEGF and thus not only add as associated mediators in the pathogenesis of DR, these also accelerate the severity of microangiopathy in T2DM.
评估脂质及脂质衍生的毒性分子在2型糖尿病（T2DM）患者糖尿病视网膜病变（DR）发病机制及严重程度中的作用。
本横断面研究纳入了14名无T2DM的健康个体（HC）、22名无DR的T2DM患者（DNR）、24名轻度非增殖性DR的T2DM患者（MNPDR）以及24名高危增殖性DR的T2DM患者（HRPDR）。所有受试者均接受血浆和玻璃体分析，分别采用标准分光光度法和酶联免疫吸附测定（ELISA）法估算总脂质（TL）、游离脂肪酸（FFA）、脂质过氧化物（LPOs，如丙二醛（MDA）、4-羟基壬烯醛（HNE））、晚期糖基化终末产物（ALE，如己酰赖氨酸（HLY））以及血管内皮生长因子（VEGF）。
与健康对照（HC）相比，T2DM患者（HRPDR＞MNPDR＞DNR）血浆和玻璃体中TL、FFA、脂质过氧化和糖基化标志物以及VEGF的浓度呈逐步显著升高。此外，在DR组中，血浆常规脂质成分如总胆固醇（TCH）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）、FFA和TL与玻璃体中不同LPOs、ALE和VEGF水平呈显著正相关。
总脂质及脂质衍生的有害生物分子最终导致VEGF分泌增加，因此不仅在DR发病机制中作为相关介质起作用，还会加速T2DM微血管病变的严重程度。
