湿性老年性黄斑变性患者血浆脂联素水平的研究

Plasma adiponectin level in patients with wet age-related macular degeneration 

摘要:

目的：观察湿性老年性黄斑变性（Age-related macular degeneration,AMD）患者的血浆脂联素(Adiponectin,APN)水平及外周血单个核细胞的APN受体1、受体2的表达水平。方法：15个患者［平均年龄(69.07±6.71)岁］和15个健康对照［平均年龄（64.2±7.46）岁］纳入本研究。所有人都不患有糖尿病、高脂血症、肾脏疾病、冠心病、心脏功能衰竭、肾脏功能衰竭等疾病。血浆APN水平由ELISA测定。外周血单个核细胞的APN受体表达水平由 Real-time PCR测定。采用Pearson相关分析处理两变量相关性分析，包括血浆APN分别与临床指标、APN受体表达水平、内环境稳态模型评估的胰岛素抵抗指数(Homeostasis model assessment insulin resistance,HOMA-IR)。结果：病例组的血浆APN水平明显低于对照组，分别是(1.18±0.65) μg/ml和(2.00±0.63) μg/ml，P=0.002。还发现病例组的血糖水平明显高于对照组,分别是(5.42±0.64) mmol/L和(4.79±0.39) mmol/L，P=0.003。但是，2组的外周血单个核细胞的APN受体的mRNA表达水平差异无统计学意义(P>0.05)。结论：血浆APN浓度在湿性AMD患者中是降低的，提示与APN相关的胰岛素抵抗可能存在于湿性AMD的病理性血管新生过程中。

Abstract:

Objective: To observe the level of plasma adiponectin (APN) in patients with wet age related macular degeneration (wet AMD) as well as the expression levels of the APN receptors (AdipoR1 and AdipoR2) in peripheral blood mononuclear cells (PBMC).Methods:Fifteen patients with an average age of (69.07±6.71) year-old (excluding patients with diabetes mellitus,hypertension,hyperlipidaemia,nephropathy,coronary heart disease,heart failure and renal failure) were enrolled as the case group while 15 healthy subjects with an average age of (64.2±7.46) year-old were enrolled as the control group.The level of plasma APN was assessed by enzyme linked immunosorbent assay and the expression levels of APN receptors in PBMC were examined by real time quantitative PCR.The correlations between plasma APN and clinical indicators,the expression levels of APN receptors,homeostasis model assessment indexes of insulin resistance (HOMA-IR) were analyzed by Pearson’s correlation.Results:APN concentrations in the case group were significantly lower than those in the control group ［(1.18±0.65) μg/ml vs.(2.00±0.63) μg /ml,P=0.002］.Blood glucose was significantly higher in the case group compared with those in the control group［(5.42±0.64)mmol/L vs.(4.79±0.39) mmol/L,P=0.003］.However,there was no significant difference in mRNA levels of AdipoR1 and AdipoR2 in PBMC between the two groups (P>0.05).Conclusion:Plasma APN concentration is lower in patients with wet AMD,indicating that APN-related insulin resistance may be involved in the pathologic neovascularization of wet AMD.