K U Vivek Ram, Siddiqi Sheelu S, Debbarman Tanusree, Mukherjee Amit, Akhtar Naheed, Waris Abdul, Thacker Dimple
Institute of Ophthalmology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (AMU), Aligarh, IND.
Rajiv Gandhi Centre for Diabetes and Endocrinology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University (AMU), Aligarh, IND.
Cureus. 2024 Nov 21;16(11):e74153. doi: 10.7759/cureus.74153. eCollection 2024 Nov.
Diabetes mellitus (DM) is a global disease that is strongly associated with both microvascular and macrovascular complications. A significant proportion of individuals with diabetes develop diabetic retinopathy (DR), a microvascular complication that can lead to blindness, particularly in working-age adults. Diabetes adversely affects the entire neurosensory retina, with accelerated neuronal apoptosis and activation or altered metabolism of neuroretinal supporting cells. These findings suggest that DR could be a sensory neuropathy that affects the retinal parenchyma, similar to peripheral diabetic neuropathy. Neurotrophins have been implicated in the progression of DR. This study was done to determine the association of serum brain-derived neurotrophic factor (BDNF) levels with DR in type 2 diabetic patients in a tertiary care hospital in North India.
A hospital-based case-control study was done. The case group included diabetic patients with retinopathy (n=44) and the control group included diabetic patients without retinopathy (n=44). Serum BDNF levels were estimated by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was carried out using GraphPad Prism software (Dotmatics, Boston, USA).
The mean serum BDNF in the control and case groups was 2753 ± 465 pg/ml and 1598 ± 483 pg/ml, respectively. The difference between the two groups was statistically significant as per the Mann-Whitney U test (U=64, p<0.0001). Logistic regression analysis showed that BDNF is a good predictor for DR after multivariate regression.
Patients with DR were found to have lower serum BDNF levels compared to those without retinopathy. BDNF may serve as an early predictor for DR. Due to its role in neuronal health and metabolism, increasing BDNF levels could offer a therapeutic approach to managing diabetes-related complications. However, further research is needed to confirm the effectiveness of BDNF in slowing or preventing the progression of DR.
糖尿病（DM）是一种全球性疾病，与微血管和大血管并发症密切相关。相当一部分糖尿病患者会发生糖尿病视网膜病变（DR），这是一种微血管并发症，可导致失明，尤其是在工作年龄的成年人中。糖尿病会对整个神经感觉视网膜产生不利影响，导致神经元凋亡加速以及神经视网膜支持细胞的激活或代谢改变。这些发现表明，DR可能是一种影响视网膜实质的感觉神经病变，类似于周围糖尿病神经病变。神经营养因子与DR的进展有关。本研究旨在确定印度北部一家三级护理医院中2型糖尿病患者血清脑源性神经营养因子（BDNF）水平与DR之间的关联。
进行了一项基于医院的病例对照研究。病例组包括患有视网膜病变的糖尿病患者（n = 44），对照组包括没有视网膜病变的糖尿病患者（n = 44）。通过酶联免疫吸附测定（ELISA）估计血清BDNF水平。使用GraphPad Prism软件（美国波士顿Dotmatics公司）进行统计分析。
对照组和病例组的平均血清BDNF分别为2753±465 pg/ml和1598±483 pg/ml。根据曼-惠特尼U检验，两组之间的差异具有统计学意义（U = 64，p < 0.0001）。逻辑回归分析表明，多变量回归后BDNF是DR的良好预测指标。
与没有视网膜病变的患者相比，发现患有DR的患者血清BDNF水平较低。BDNF可能作为DR的早期预测指标。由于其在神经元健康和代谢中的作用，提高BDNF水平可能为管理糖尿病相关并发症提供一种治疗方法。然而，需要进一步研究来证实BDNF在减缓或预防DR进展方面的有效性。
