Zhang Weiyi, Zou Yu-Ling
The Affiliated Eye Hospital, Jiangxi Medical College, Nanchang University, Jiangxi Province Key Laboratory of Ophthalmology and Vision Sciences, Jiangxi Clinical Research Center for Ophthalmic Disease, Jiangxi Provincial Key Laboratory of Vitreoretinal Diseases for Health, Nanchang, 330006, Jiangxi, China.
Sci Rep. 2025 Sep 26;15(1):33009. doi: 10.1038/s41598-025-18317-y.
Abnormalities in lipid metabolism play an important role in diabetic macular edema (DME), and the aim of this study was to investigate the correlation between ApoB/A1 levels and best corrected visual acuity (BCVA) and macular microstructural changes in DME patients after anti-VEGF treatment. Through a retrospective cohort analysis of 61 patients (61 eyes) with non-proliferative diabetic retinopathy combined with macular edema treated with 3 + PRN anti-VEGF regimen and followed up for three months, grouped by median ApoB/A1, the differences between the efficacy indexes of the two groups were compared. The results showed that the macular edema regression rate was significantly higher in the high ApoB/A1 ratio group than in the low ratio group at one month after treatment(P < 0.05), and at three months after treatment, the high ApoB/A1 ratio group was better than the low ratio group in BCVA improvement (58.1% vs. 26.7%), inner retinal layer restoration (38.7% vs. 10.0%), and hyperreflective foci (HF) reduction (41.9% vs. 6.7%). aspects were better than those in the low ratio group (P < 0.05). The results of ordered logistic regression analysis showed that the ApoB/A1 ratio was significantly correlated with the change in macular edema at one month after treatment and the change in the number of HF at three months after treatment. Conclusions showed that the ApoB/A1 ratio was significantly correlated with short-term improvement of BCVA and macular microstructure after anti-VEGF treatment in DME patients, and it is expected to be used as an objective biomarker for assessing the efficacy of anti-VEGF treatment in DME patients.
脂质代谢异常在糖尿病性黄斑水肿（DME）中起重要作用，本研究旨在探讨载脂蛋白B/载脂蛋白A1（ApoB/A1）水平与DME患者抗血管内皮生长因子（VEGF）治疗后最佳矫正视力（BCVA）及黄斑微结构变化之间的相关性。通过对61例（61只眼）非增殖性糖尿病视网膜病变合并黄斑水肿患者采用3+PRN抗VEGF方案治疗并随访3个月的回顾性队列分析，以ApoB/A1中位数分组，比较两组疗效指标的差异。结果显示，治疗1个月时，高ApoB/A1比值组黄斑水肿消退率显著高于低比值组（P<0.05）；治疗3个月时，高ApoB/A1比值组在BCVA改善（58.1%对26.7%）、视网膜内层恢复（38.7%对10.0%）和高反射灶（HF）减少（41.9%对6.7%）方面均优于低比值组（P<0.05）。有序逻辑回归分析结果显示，ApoB/A1比值与治疗1个月时黄斑水肿变化及治疗3个月时HF数量变化显著相关。结论表明，ApoB/A1比值与DME患者抗VEGF治疗后BCVA和黄斑微结构的短期改善显著相关，有望作为评估DME患者抗VEGF治疗疗效的客观生物标志物。
