Department of Internal Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor Darul Ehsan, Malaysia.
Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor Darul Ehsan, Malaysia.
BMC Ophthalmol. 2022 Sep 3;22(1):357. doi: 10.1186/s12886-022-02550-4.
Diabetic retinopathy (DR) is a serious complication of longstanding type 2 diabetes mellitus (T2DM), a leading cause of blindness and visual disability in the world. The aim of this study is to compare the activity of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) in tears and serum of patients with DR and those without DR.
Among the T2DM patients enrolled in this study, 26 patients had DR (n = 26) while 29 were without DR (n = 29). The blood and tear samples were obtained from all participants. The level of PAI-1 and tPA were measured in both the serum and tears. Anthropometric measurements, HbA1c, renal and lipid profile were also obtained.
Patients with DR had significantly longer disease duration and higher systolic blood pressure compared to those without DR. Serum PAI-1 level was significantly higher in patients with DR compared to those without DR, 32.72 (IQR 32.52) vs 21.37 (IQR 14.93) ng/mL, respectively (p < 0.05). However, tear PAI-1 were comparable in both groups. Serum and tear tPA levels in both groups were also comparable (p > 0.05). Among patients with DR, there were no significant correlations between tear and serum of both biomarkers. Patients without DR showed a moderate positive correlation between serum and tear tPA levels with a coefficient of 0.363, albeit no statistical significance. Patients with DR demonstrated a significant positive correlation between levels of tears PAI-1 and BMI (r = 0.555, p = 0.026). In the group without DR, there was a statistically significant positive correlation between serum level of PAI-1 with urine albumin creatinine ratio (UACR) (r = 0.501, p = 0.013).
The present study demonstrated a significantly greater serum PAI-1 levels in patients with DR compared to those without DR. No significant correlations between tears and serum PAI-1 and tPA were observed. Thus, the role of tear biomarkers remains relevant for further investigations.
糖尿病视网膜病变（DR）是长期 2 型糖尿病（T2DM）的严重并发症，是世界上导致失明和视力障碍的主要原因。本研究旨在比较 DR 患者和无 DR 患者的泪液和血清中组织纤溶酶原激活物（tPA）和纤溶酶原激活物抑制剂-1（PAI-1）的活性。
在本研究纳入的 T2DM 患者中，26 例患者患有 DR（n=26），29 例患者无 DR（n=29）。所有参与者均采集血和泪样。测量血清和泪液中的 PAI-1 和 tPA 水平。还获得了人体测量学测量值、HbA1c、肾功能和血脂谱。
与无 DR 的患者相比，DR 患者的疾病持续时间明显更长，收缩压也更高。与无 DR 的患者相比，DR 患者的血清 PAI-1 水平明显更高，分别为 32.72（IQR 32.52）和 21.37（IQR 14.93）ng/ml（p<0.05）。然而，两组的泪液 PAI-1 水平相当。两组的血清和泪液 tPA 水平也相当（p>0.05）。在 DR 患者中，泪液和血清两种生物标志物之间没有明显的相关性。无 DR 的患者中，血清和泪液 tPA 水平之间存在中度正相关，相关系数为 0.363，但无统计学意义。DR 患者的泪液 PAI-1 水平与 BMI 呈显著正相关（r=0.555，p=0.026）。在无 DR 的患者中，血清 PAI-1 水平与尿白蛋白肌酐比（UACR）呈统计学显著正相关（r=0.501，p=0.013）。
本研究表明，DR 患者的血清 PAI-1 水平明显高于无 DR 的患者。泪液和血清 PAI-1 和 tPA 之间无明显相关性。因此，泪液生物标志物的作用仍值得进一步研究。
