Study on the relationship among high molecular weight adiponectin, tumor necrosis factor-α and vascular endothelial growth factor with diabetic retinopathy

doi:10.3877/cma.j.issn.2095-2007.2017.04.003

Abstract

Abstract:

Objective

To discuss the relationship among high molecular weight adiponectin (HMW-ADP), tumor necrosis factor(TNF)-α and vascular endothelial growth factor(VEGF) with diabetic retinopathy(DR).

Methods

150 cases with type 2 diabetes mellitus from January to December 2014 were selected as study objects, 50 cases with NDR, 50 cases with NPDR and 50 cases with PDR. 50 cases for physical examination were selected as control group. Compared with the gender, history of hypertension and diabetes family history of χ²test. The clinical data such as HMW-ADP, TNF-α, VEGF, biochemical indexes and body mass index were all expressed by mean and standard deviation (±s), and compared by single factor analysis of variance. The effects of HMW-ADP, TNF-α, VEGF and other factors on NPDR and PDR were analyzed by multiple Logistic regression. The correlation of HMW-ADP, TNF-α and VEGF with DR was analyzed by Pearson correlation.

Results

The age of the NPDR group and the PDR group were larger than that of the NDR group and the control group (F=5.329, P<0.05). The history of hypertension in group NDR, group NPDR and group PDR were significantly higher than that of control group (χ²=20.215, P<0.05). The patients in group PDR had the longest course, followed by group NPDR, and the group NDR was the shortest (F=96.434, P<0.05). Fasting blood glucose in patients in group NDR, group NPDR and group PDR were significantly higher than that of control group (F=12.510, P<0.05). The fasting insulin levels in group PDR were the highest, followed by group NPDR and group NDR, and lowest in the control group (F=25.305, P<0.05). The content of triglyceride (TG) in patients in group NDR, group NPDR and group PDR were significantly higher than that of control group (F=16.419, P<0.05). The content of high-density lipoprotein cholesterol (HDL-C) was significantly lower than that of the control group (F=4.259, P<0.05). The creatinine of group NPDR and group PDR was significantly higher than that of control group (F=47.158, P<0.05). The difference between the two groups was statistically significant. The level of HMW-ADP in the NPDR group and the PDR group were significantly lower than that in the control group and the NDR group, and the NDR group was significantly lower than that of the control group, the difference between the two groups was statistically significant (F=362.480, P<0.05). The levels of TNF-α and VEGF in group PDR were the highest, followed by NPDR group; NDR group and control group were lowest, the difference between the two groups were statistically significant (F=239.200, 641.970; P<0.05). Multivariate analysis showed that age, duration of disease, TNF-α and VEGF were independent risk factors for NPDR (χ²=7.621, 18.331, 5.532, 5.618; P<0.05), and they were also independent risk factors for PDR (χ²=6.962, 11.542, 5.615, 5.331; P<0.05). HDL-C and HMW-ADP were protective factors for NPDR (χ²=6.694, 10.671; P<0.05), and they were also protective factors for PDR (χ²=5.674, 7.671; P<0.05). The levels of HMW-ADP in patients with DR were negatively correlated with TNF-α and VEGF (r=-0.328, -0.810; P<0.05).

Conclusion

In patients with DR, the level of HMW-ADP decreases, and the levels of TNF-α and VEGF increase; Multivariate analysis shows that HMW-ADP is protective factor, and TNF-α and VEGF are risk factor; HMW-ADP is negatively correlated with TNF-α and VEGF.

Key words: High molecular weight adiponectin, Tumor necrosis factor-α, Vascular endothelial growth factor, Diabetic retinopathy

Pei Yan, Li Zhang, Xiaohong Zhang, Yankun Zhang. Study on the relationship among high molecular weight adiponectin, tumor necrosis factor-α and vascular endothelial growth factor with diabetic retinopathy[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2017, 07(04): 158-164.

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Figures/Tables 6

References 57

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组别	性别(男/女)	平均年龄(岁)	平均病程(年)	空腹血糖(mmol/L)	空腹胰岛素(miu/L)	身体质量指数(kg/m²)	收缩压(mmHg)
对照组	28/22	50.9±10.3	0	5.16±0.58	10.20±3.02	24.51±1.03	125.1±6.9
NDR组	26/24	51.2± 9.8	4.3±1.5	6.33±1.84	12.18±3.55	24.68±1.16	127.0±7.1
NPDR组	29/21	56.1±11.0	11.1±3.3	6.75±2.01	14.14±3.61	24.54±1.21	130.5±7.0
PDR组	26/24	57.6±10.6	13.6±3.6	7.06±1.82	16.10±4.02	24.41±1.35	132.6±7.3
统计量	0.544^*	5.329	96.434	12.510	25.305	0.583	0.440
P值	>0.05	<0.05	<0.05	<0.05	<0.05	>0.05	>0.05
组别	舒张压(mmHg)	TG(mmol/L)	总胆固醇(mmol/L)	HDL－C(mmol/L)	LDL－C(mmol/L)	高血压病史(有/无)	糖尿病家族病史(有/无)	肌氨酸酐(μmol/L)
对照组	80.3±4.4	1.41±0.50	5.10±1.41	1.53±0.51	3.11±1.01	0/50	6/44	53.3±9.3
NDR组	79.8±4.6	2.10±0.52	5.41±1.55	1.42±0.48	3.15±1.21	14/36	9/41	58.1±8.9
NPDR组	80.5±4.1	1.88±0.49	5.45±1.58	1.23±0.46	3.19±1.33	16/34	5/45	64.1±7.7
PDR组	80.8±4.9	1.90±0.53	5.43±1.57	1.25±0.51	3.20±1.38	16/34	7/43	72.5±8.1
统计量	0.434	16.419	0.587	4.259	0.055	20.215^*	1.499^*	47.158
P值	>0.05	<0.05	>0.05	<0.05	>0.05	<0.05	>0.05	<0.05

组别	性别(男/女)	平均年龄(岁)	平均病程(年)	空腹血糖(mmol/L)	空腹胰岛素(miu/L)	身体质量指数(kg/m²)	收缩压(mmHg)
对照组	28/22	50.9±10.3	0	5.16±0.58	10.20±3.02	24.51±1.03	125.1±6.9
NDR组	26/24	51.2± 9.8	4.3±1.5	6.33±1.84	12.18±3.55	24.68±1.16	127.0±7.1
NPDR组	29/21	56.1±11.0	11.1±3.3	6.75±2.01	14.14±3.61	24.54±1.21	130.5±7.0
PDR组	26/24	57.6±10.6	13.6±3.6	7.06±1.82	16.10±4.02	24.41±1.35	132.6±7.3
统计量	0.544^*	5.329	96.434	12.510	25.305	0.583	0.440
P值	>0.05	<0.05	<0.05	<0.05	<0.05	>0.05	>0.05
组别	舒张压(mmHg)	TG(mmol/L)	总胆固醇(mmol/L)	HDL－C(mmol/L)	LDL－C(mmol/L)	高血压病史(有/无)	糖尿病家族病史(有/无)	肌氨酸酐(μmol/L)
对照组	80.3±4.4	1.41±0.50	5.10±1.41	1.53±0.51	3.11±1.01	0/50	6/44	53.3±9.3
NDR组	79.8±4.6	2.10±0.52	5.41±1.55	1.42±0.48	3.15±1.21	14/36	9/41	58.1±8.9
NPDR组	80.5±4.1	1.88±0.49	5.45±1.58	1.23±0.46	3.19±1.33	16/34	5/45	64.1±7.7
PDR组	80.8±4.9	1.90±0.53	5.43±1.57	1.25±0.51	3.20±1.38	16/34	7/43	72.5±8.1
统计量	0.434	16.419	0.587	4.259	0.055	20.215^*	1.499^*	47.158
P值	>0.05	<0.05	>0.05	<0.05	>0.05	<0.05	>0.05	<0.05

组别	例数	HMW－ADP(μg/ml)	TNF－α(μg/L)	VEGF(μg/L)
对照组	50	2.51±0.26	6.8±1.6	52.1±11.3
NDR组	50	1.65±0.20^△	8.0±1.8^△	120.6±15.5^△
NPDR组	50	1.44±0.18^△▲	11.9±1.6^△▲	160.6±21.2^△▲
PDR组	50	1.45±0.13^△▲	16.6±2.9^△▲	225.3±28.7^△▲
F值	?	362.480	239.200	641.970
P值	?	<0.05	<0.05	<0.05

组别	例数	HMW－ADP(μg/ml)	TNF－α(μg/L)	VEGF(μg/L)
对照组	50	2.51±0.26	6.8±1.6	52.1±11.3
NDR组	50	1.65±0.20^△	8.0±1.8^△	120.6±15.5^△
NPDR组	50	1.44±0.18^△▲	11.9±1.6^△▲	160.6±21.2^△▲
PDR组	50	1.45±0.13^△▲	16.6±2.9^△▲	225.3±28.7^△▲
F值	?	362.480	239.200	641.970
P值	?	<0.05	<0.05	<0.05

项目	回归系数	标准误	Waldχ²	P值	OR值	95%可信区间
年龄	0.038	0.012	7.621	<0.05	1.056	1.013～1.072
病程	0.582	0.081	18.331	<0.05	1.913	1.346～2.335
HDL－C	－1.318	0.451	6.694	<0.05	0.335	0.128～0.649
TNF－α	0.201	0.076	5.532	<0.05	1.361	1.058～1.943
HMW－ADP	－0.805	0.212	10.671	<0.05	0.494	0.106～0.893
VEGF	0.381	0.064	5.618	<0.05	1.895	1.173～2.205

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