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目的检测糖尿病患者血清中血糖、糖化血红蛋白(HbA1c)、结缔组织生长因子(CTGF)、血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)表达情况,应用ROC曲线统计分析HbA1c、CTGF、VEGF、IL-6在糖尿病性视网膜病变早期诊断中价值。方法收集糖尿病患者205例;根据散瞳眼底造影结果,患者分为糖尿病视网膜病变(DR)早期(非增殖型)组68例、DR晚期(增殖型)组40例、无糖尿病视网膜病变组(NDR)组97例;抽取静脉血,检测空腹血糖(FPG)、HbA1c的表达情况,ELISA法检测所有患者血清中CTGF、VEGF、IL-6的表达情况;分析HbA1c与CTGF、VEGF、IL-6的相关性;ROC曲线分析HbA1c、CTGF、VEGF、IL-6在早期DR诊断中的价值。结果相比于NDR组,早期DR组以及晚期DR组患者血清中HbA1c、CTGF、VEGF、IL-6升高;3组间FPG差异无统计学意义(P>0.05);CTGF、VEGF、IL-6与HbA1c均呈正相关(r值分别为0.448 2、0.324 4、0.748 0,P<0.01);在早期DR的诊断中,HbA1c、CTGF、VEGF、IL-6的AUC值分别为0.66、0.72、0.68、0.71;HbA1c+CTGF+VEGF+IL-6联合检测时,AUC值为0.91。结论 HbA1c、CTGF、VEGF、IL-6在DR患者血清中表达增加,可作为DR筛查的标志物,HbA1c、CTGF、VEGF、IL-6联合检测可提高早期DR诊断的敏感性和特异性。
Objective To detect the expression of HbA1c, CTGF, VEGF and IL-6 in serum of patients with diabetes mellitus (T2DM). The ROC curve was used to analyze the expression of HbA1c, The value of CTGF, VEGF and IL-6 in the early diagnosis of diabetic retinopathy. Methods Totally 205 diabetic patients were collected. According to the results of mydriasis fundus, 68 patients were divided into two groups: early diabetic retinopathy (DR) group (68 cases), late DR (proliferative group) group, non-diabetic retinopathy group ) Group (n = 97). Venous blood was collected for the detection of fasting blood glucose (FPG) and HbA1c expression. ELISA was used to detect the expression of CTGF, VEGF and IL-6 in all the patients. The levels of HbA1c, CTGF, VEGF and IL- ROC curve analysis of HbA1c, CTGF, VEGF, IL-6 in the diagnosis of early DR value. Results Compared with NDR group, the levels of serum HbA1c, CTGF, VEGF and IL-6 in early DR group and advanced DR group were significantly increased. There was no significant difference in FPG between the three groups (P> 0.05) 6 were positively correlated with HbA1c (r = 0.448,0.324 4,0.748 0, P <0.01). The AUC of HbA1c, CTGF, VEGF and IL-6 were 0.66 and 0.72 respectively in the diagnosis of early DR, 0.68, 0.71; AUC value of 0.91 for HbA1c + CTGF + VEGF + IL-6. Conclusion The expression of HbA1c, CTGF, VEGF and IL-6 in the serum of patients with DR increased and could be used as a marker of DR screening. The combined detection of HbA1c, CTGF, VEGF and IL-6 could improve the sensitivity and specificity of early DR diagnosis.