Relationship between vitreous and serum vascular endothelial growth factor levels, control of diabetes and microalbuminuria in proliferative diabetic retinopathy.
Relationship between vitreous and serum vascular endothelial growth factor levels, control of diabetes and microalbuminuria in proliferative diabetic retinopathy.
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DOI：
10.2147/opth.s27423
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Mohajeri A
中科院分区：
文献类型：
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作者：
Baharivand N;Zarghami N;Panahi F;Dokht Ghafari MY;Mahdavi Fard A;Mohajeri A
糖尿病视网膜病变是一种严重的视网膜微血管病变。血管内皮生长因子（VEGF）的表达，诱导高糖水平和缺氧，是视网膜病变的主要特征。本研究的目的是评估增生性糖尿病视网膜病变患者玻璃体和血清VEGF水平与糖尿病和微量白蛋白尿控制之间的关系。65例患者入组本病例对照研究，包括30例增殖性糖尿病视网膜病变患者（病例）和35例非增殖性糖尿病视网膜病变患者（对照）。比较两组玻璃体VEGF水平与血清VEGF水平。糖化血红蛋白（HbA 1c），微量白蛋白尿，血清肌酐，肾病和视网膜病变的阶段，还测量了增生性糖尿病视网膜病变患者，这些参数和血清和玻璃体VEGF水平之间的关系进行了研究。平均玻璃体和血清VEGF水平显著高于对照组（P = 0.001，P = 0.011，分别）。玻璃体VEGF水平与血清VEGF水平呈显著正相关（P = 0.012，r = 0.453）。血糖控制良好（P = 0.039）、药物治疗（P = 0.045）和肾病早期（P = 0.042）的患者的VEGF水平明显较低。VEGF与白蛋白/肌酐比值呈显著相关（P = 0.017，r = 0.432）。口服治疗的患者、视网膜病变控制良好的患者和早期视网膜病变患者的血清和玻璃体VEGF水平显著降低。给予抗VEGF抗体对减少增殖性糖尿病视网膜病变的进展具有良好的效果。
Diabetic retinopathy is a serious microvascular disorder of the retina. Vascular endothelial growth factor (VEGF) expression, induced by high glucose levels and hypoxia, is a main feature in retinopathy. The aim of this study was to evaluate the relationship between vitreous and serum VEGF levels and control of diabetes and microalbuminuria in patients with proliferative diabetic retinopathy. Sixty-five patients were enrolled in this case-control study, comprising 30 patients with proliferative diabetic retinopathy (cases) and 35 patients with nonproliferative diabetic retinopathy (controls). The vitreous VEGF level was compared with the serum VEGF level in both groups. Glycosylated hemoglobin (HbA1c), microalbuminuria, serum creatinine, and stage of nephropathy and retinopathy were also measured in patients with proliferative diabetic retinopathy, and the relationship between these parameters and serum and vitreous VEGF levels was investigated. Mean vitreous and serum VEGF levels were significantly higher in cases compared with controls (P = 0.001, P = 0.011, respectively). There was also a significant correlation between vitreous and serum VEGF levels (P = 0.012, r = 0.453). VEGF levels in patients with well controlled blood glucose (P = 0.039), on drug treatment (P = 0.045) and at an early stage of nephropathy (P = 0.042) were significantly lower. There was a significant correlation between VEGF and albumin to creatinine ratio (P = 0.017, r = 0.432). Serum and vitreous VEGF levels was significantly lower in patients on oral therapy, in those with well controlled glycemia, and in those with early-stage retinopathy. Administration of anti-VEGF had a good effect in reducing the progression of proliferative diabetic retinopathy.