SCG3在糖尿病视网膜病变患者玻璃体液和外周血中表达的研究

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目的:探讨糖尿病视网膜病变(DR)患者外周血和玻璃体液中分泌颗粒蛋白Ⅲ(SCG3)的表达情况。方法:横断面研究。收集2018年5至12月于天津医科大学眼科医院玻璃体视网膜科接受玻璃体切除术的患者77例(77只眼),年龄(60.75±11.34)岁,男性41例,女性36例。根据血糖水平、糖尿病病史和眼底表现分为DR组和非糖尿病组,进一步按血脂水平和体重指数(BMI)分为血脂偏高和血脂正常、BMI偏高和BMI正常者分别进行观察。所有患者进行眼部检查,根据身高和体重计算BMI,取外周血检测血脂水平。患者于玻璃体切除术中取玻璃体液,采用酶联免疫吸附测定(ELISA)法测定所有患者玻璃体液标本中及外周血血浆中的SCG3。应用Wilcoxon秩和检验对SCG3浓度进行统计学比较。结果:DR组患者43例,其中脂血偏高25例,正常18例;BMI偏高22例,正常21例。非糖尿病组34例,其中脂血偏高13例,正常21例;BMI偏高17例,正常17例。DR组SCG3[6.02(4.34,11.76)ng/ml]高于非糖尿病组[4.30(3.20,10.78)ng/ml](n Z=-2.339,n P<0.01)。DR组中血脂偏高者的SCG3[7.94(5.33,13.51)ng/ml]高于非糖尿病组中血脂者正常者[4.04(3.12,7.77)ng/ml](n Z=-3.473,n P<0.01)。DR组中血脂偏高者的SCG3高于血脂者正常者[4.45(3.71,9.14)ng/ml](n Z=-2.511,n P<0.01)。DR组中BMI较高者的SCG3[7.12(4.56,13.12)ng/ml]高于非糖尿病组BMI正常者[3.53(3.16,4.38)ng/ml](n Z=-3.767,n P<0.01)。DR组中BMI正常者的SCG3[5.72(4.10,11.60)ng/ml]高于非糖尿病组BMI正常者(n Z=-2.862,n P<0.01)。血浆中的SCG3极少或无法检测到。n 结论:DR患者玻璃体液中SCG3表达上调,但SCG3几乎很难在正常的血管系统中被检测到。n (中华眼科杂志,2020,56:933-937)“,”Objective:To study the expression levels of secretogranin Ⅲ (SCG3) in the peripheral blood and vitreous of patients with diabetic retinopathy (DR).Methods:Cross-sectional research. A total of 77 patients (41 men and 36 women, 77 eyes) received vitrectomy in Tianjin Medical University Eye Hospital from May to December 2018, with an average age of (60.75±11.34) years. According to the blood glucose level, diabetes history and fundus status, all the patients were divided into the DR group and the non-diabetic group. According to the patients′ blood lipids and body mass index (BMI), patients were further divided into subgroups of high blood lipids, normal blood lipids, high BMI and normal BMI. All patients were tested with eye examinations, height and weight to calculate the BMI, and blood lipid levels in the peripheral blood. The vitreous was collected during the vitrectomy surgery, and the levels of SCG3 in the vitreous and peripheral blood were analyzed by ELISA. All the data were analyzed statistically with Wilcoxon rank sum test.Results:There were 43 patients in the DR group, among whom 25 had hyperlipidemia, 18 had normal blood lipids, 22 had a high BMI, and 21 had a normal BMI. There were 34 patients in the non-diabetic group, among whom 13 had hyperlipidemia, 21 had normal blood lipids, 17 had a high BMI, and 17 had a normal BMI. The level of SCG3 in the DR group [6.02 (4.34, 11.76) ng/ml] was higher than that in the non-diabetic group [4.30 (3.20, 10.78) ng/ml] (n Z=-2.339, n P =0.019). The level of SCG3 in the hyperlipidemia subgroup of the DR patients [7.94 (5.33, 13.51) ng/ml] was higher than that in the normal blood lipid subgroup of the non-diabetic patients [4.04 (3.12, 7.77) ng/ml] (n Z=-3.473, n P=0.001), and higher than that in the DR patients without hyperlipidemia [4.45 (3.71, 9.14) ng/ml] (n Z=-2.511, n P=0.012). The level of SCG3 in the DR patients with a high BMI [7.12 (4.56, 13.12) ng/ml] was higher than that in the non-diabetic patients with a normal BMI [3.53 (3.16, 4.38) ng/ml] (n Z=-3.767, n P =0.000). The level of SCG3 in the DR patients with a normal BMI [5.72 (4.10, 11.60) ng/ml] was higher than that in the non-diabetic patients with a normal BMI (n Z=-2.862, n P = 0.004). SCG3 in the plasma was rare or can not be detected.n Conclusions:The concentration of SCG3 in the vitreous increase in DR patients. However, SCG3 can not be detected in the healthy vascular system.n (Chin J Ophthalmol, 2020, 56: 933-937)
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