Expression and significance of serum chemokine and fibroblast growth factor 21 in patients with diabetic retinopathy
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摘要:目的 观察糖尿病视网膜病变患者血清趋化素(Chemerin)和成纤维细胞生长因子21(FGF21)表达情况，并探讨血清Chemerin、FGF21对糖尿病视网膜病变的诊断价值。方法 选取90例糖尿病视网膜病变患者纳入观察组，并随机选取同期85例健康体检者纳入对照组。比较2组血清Chemerin、FGF21、糖化血红蛋白(HbAlc)、空腹血糖(FBG)水平，并比较病情严重程度不同的糖尿病视网膜病变患者的Chemerin、FGF21、HbAlc、FBG水平，分析血清Chemerin、FGF21与HbAlc、FBG的相关性，采用受试者工作特征(ROC)曲线评估血清Chemerin、FGF21对糖尿病视网膜病变的诊断价值。结果 观察组血清Chemerin、FGF21水平高于对照组，差异有统计学意义(P < 0.05); 增殖型糖尿病视网膜病变患者的血清Chemerin、FGF21水平高于非增殖型糖尿病视网膜病变患者，差异有统计学意义(P < 0.05); 相关性分析结果显示，Chemerin、FGF21均分别与HbAlc、FBG呈显著正相关(P < 0.05); Logistic回归分析结果显示，血清Chemerin、FGF21与患者预后显著相关(P < 0.05); ROC曲线评估结果显示，血清Chemerin、FGF21联合检测诊断糖尿病视网膜病变的敏感度、特异性、准确度均高于单独检测，差异有统计学意义(P < 0.05)。结论 糖尿病视网膜病变患者血清Chemerin、FGF21表达均与HbAlc、FBG水平密切相关，可作为早期鉴别诊断糖尿病视网膜病变的标记物，且联合检测对糖尿病视网膜病变具有较高的诊断价值。
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关键词:
- 趋化素 /
- 成纤维细胞生长因子21 /
- 糖尿病视网膜病变 /
- 诊断 /
- 预后
Abstract:Objective To observe expressions of serum chemokine and fibroblast growth factor 21(FGF21) in patients with diabetic retinopathy in serum of diabetic retinopathy and their values in diagnosing diabetic retinopathy.Methods A total of 90 patients with diabetic retinopathy admitted to our hospital were selected as observation group. At the same time, 85 people with physical examinations were randomly selected as control group. Serum Chemerin, FGF21, glycosylated hemoglobin(HbAlc), fasting blood glucose (FBG) levels were compared between the two groups, and the levels of Chemerin, FGF21, HBALC, FBG in diabetic retinopathy patients with different severity of disease were compared. The correlations between serum Chemerin, FGF21 and HbAlc, FBG were analyzed, and the diagnostic value of serum Chemerin and FGF21 in diabetic retinopathy was evaluated by Receiver Operating Characteristic (ROC) curve.Results The serum levels of Chemerin and FGF21 in the observation group were significantly higher than those in the control group (P < 0.05). Serum levels of Chemerin and FGF21 in the proliferative diabetic retinopathy patients were significantly higher than those with nonproliferative diabetic retinopathy (P < 0.05). The correlation analysis results showed that Chemerin and FGF21 were significantly positively correlated with HbAlc and FBG, respectively The serum levels of Chemerin and FGF21 in the observation group were significantly higher than those in the control group (P < 0.05). Serum levels of Chemerin and FGF21 in the proliferative diabetic retinopathy patients were significantly higher than those with nonproliferative diabetic retinopathy (P < 0.05). The correlation analysis results showed that Chemerin and FGF21 were significantly positively correlated with HbAlc and FBG, respectively with prognosis (P < 0.05). ROC curve evaluation results showed that the sensitivity, specificity and accuracy of serum combined detection of Chemerin and FGF21 in the diagnosis of diabetic retinopathy were higher than those of single detection (P < 0.05).Conclusion The expressions of serum Chemerin and FGF21 in patients with diabetic retinopathy are closely related to the levels of HbAlc and FBG, which can be used as markers for early differential diagnosis of diabetic retinopathy, and combined detection has a high diagnostic value for diabetic retinopathy.-
Keywords:
- chemotaxis element /
- fibroblast growth factor 21 /
- diabetic retinopathy /
- diagnosis /
- prognosis
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图 1 Chemerin、FGF21与HbAlc、FBG的相关性分析散点图
A: Chemerin与HbAlc的相关性; B: Chemerin与FBG的相关性; C: FGF21与HbAlc的相关性; D: FGF21与FBG的相关性。
表 1 2组血清Chemerin、FGF21、HbAlc、FBG水平比较(x±s)
组别 n Chemerin/(μg/L) FGF21/(pg/mL) HbAlc/% FBG/(mmol/L) 对照组 85 12.34±3.51 172.25±24.08 5.52±0.61 6.82±1.21 观察组 90 34.57±7.74* 335.16±29.18* 9.35±1.47* 10.29±1.35* Chemerin: 趋化素; FGF21: 成纤维细胞生长因子21; HbAlc: 糖化血红蛋白; FBG: 空腹血糖。与对照组比较, *P < 0.05。 
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表 2 不同病情严重程度患者血清Chemerin、FGF21、HbAlc、FBG水平比较(x±s)
组别 n Chemerin/(μg/L) FGF21/(pg/mL) HbAlc/% FBG/(mmol/L) 非增殖型糖尿病视网膜病变组 53 29.58±7.71 286.95±28.19 8.61±1.39 9.58±1.47 增殖型糖尿病视网膜病变组 37 41.72±7.93* 404.22±29.17* 10.41±1.45* 11.31±1.52* Chemerin: 趋化素; FGF21: 成纤维细胞生长因子21; HbAlc: 糖化血红蛋白; FBG: 空腹血糖。
与非增殖型糖尿病视网膜病变组比较, *P < 0.05。
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表 3 血清Chemerin、FGF21与糖尿病视网膜病变预后的Logistic回归分析
变量 OR 95%CI P Chemerin 1.06 1.01~1.09 0.002 FGF21 1.15 1.08~1.23 0.001 Chemerin: 趋化素; FGF21: 成纤维细胞生长因子21。
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表 4 血清Chemerin、FGF21对糖尿病视网膜病变的诊断价值
检验变量 曲线下面积 P 95%CI 敏感度/% 特异度/% 准确度/% 约登指数 截断值 Chemerin 0.995 < 0.001 0.988~1.000 83.56 79.15 82.05 0.51 0.44 FGF21 0.985 < 0.001 0.973~0.998 84.25 78.52 81.16 0.57 0.45 联合检测 0.999 < 0.001 0.997~1.000 93.67 89.36 94.15 0.58 0.51 Chemerin: 趋化素; FGF21: 成纤维细胞生长因子21。
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