2型糖尿病患者血清ADAM10、FGF23水平与糖尿病视网膜病变的相关性研究-现代医学

2型糖尿病患者血清ADAM10、FGF23水平与糖尿病视网膜病变的相关性研究

作者：姚娜

单位：长治市人民医院内分泌科, 山西长治 046000

关键词：2型糖尿病解整合素金属蛋白酶10 成纤维细胞生长因子23 糖尿病视网膜病变相关性

分类号：R587.1;R774.1

出版年·卷·期（页码）：2025·53·第九期（1431-1437）

摘要：

目的： 探讨2型糖尿病(T2DM)患者血清解整合素金属蛋白酶10(ADAM10)、成纤维细胞生长因子23(FGF23)水平与糖尿病视网膜病变(DR)的关系。方法： 纳入长治市人民医院内分泌科2023年5~11月收治的100例T2DM患者，依据DR诊断标准分为DR组(40例)及非DR组(60例)，收集并比较两组患者年龄、性别、体质量指数、饮酒史、吸烟史等一般资料；酶联免疫吸附法检测患者血清FGF23、ADAM10水平；Pearson相关系数分析其相关性；受试者工作特征曲线分析其诊断效能；Logistic回归分析T2DM患者发生DR的影响因素。结果： 与非DR组相比，DR组患者的糖尿病病程、糖化血红蛋白、C肽、低密度脂蛋白、空腹血糖均显著增加(均P<0.05)；血清FGF23、ADAM10水平均显著增加(均P<0.05)。与非增殖性DR组相比，增殖性DR组T2DM患者血清FGF23、ADAM10水平均显著增加(均P<0.05)。Pearson相关分析显示，DR患者血清FGF23与ADAM10水平呈正相关性(r=0.713，P＜0.001)；DR患者血清FGF23、ADAM10水平与糖尿病病程、低密度脂蛋白、空腹血糖及糖化血红蛋白均呈正相关，而与C肽呈负相关(P<0.01)。Logistic回归分析显示，糖尿病病程及血清FGF23、ADAM10水平为T2DM发生DR的影响因素(P＜0.05)。血清FGF23、ADAM10及二者联合预测T2DM患者发生DR的曲线下面积分别为0.869、0.953、0.973，灵敏度分别为90.00%、95.00%、87.50%，特异度分别为70.00%、85.00%、95.00%。结论： 血清FGF23、ADAM10水平与T2DM患者发生DR密切相关，是T2DM患者发生DR的独立危险因素，可辅助诊断T2DM患者合并DR，且联合诊断效能更佳。

Objective: To investigate the relationship between serum levels of a disintegrin and metalloproteinase 10(ADAM10) and fibroblast growth factor 23(FGF23) and diabetic retinopathy(DR) in patients with type 2 diabetes mellitus(T2DM). Methods: A total of 100 T2DM patients admitted to the Department of Endocrinology, Changzhi People's Hospital, between May and November 2023 were enrolled. According to the diagnostic criteria for DR, the patients were divided into a DR group(n=40) and a non-DR group(n=60). General clinical data, including age, gender, body mass index, history of alcohol consumption, and smoking history, etc were collected and compared between the two groups. Serum levels of FGF23 and ADAM10 were measured using enzyme-linked immunosorbent assay. Pearson correlation analysis was used to evaluate their correlations. Receiver operating characteristic curve analysis was applied to assess diagnostic efficacy. Logistic regression analysis was performed to identify influencing factors for DR development in T2DM patients. Results: Compared with the non-DR group, the DR group showed significant increases in diabetes duration, glycated hemoglobin, C-peptide, low-density lipoprotein, and fasting blood glucose(all P<0.05). Serum levels of FGF23 and ADAM10 were also significantly elevated in the DR group(all P<0.05). Furthermore, patients with proliferative DR had significantly higher serum FGF23 and ADAM10 levels than those with non-proliferative DR(all P<0.05). Pearson correlation analysis revealed a positive correlation between serum FGF23 and ADAM10 levels in DR patients(r=0.713, P<0.001). In DR patients, both FGF23 and ADAM10 levels were positively correlated with diabetes duration, low-density lipoprotein, fasting blood glucose, and glycated hemoglobin, but negatively correlated with C-peptide(P<0.01). Logistic regression analysis indicated that diabetes duration and serum levels of FGF23 and ADAM10 were independent influencing factors for DR in T2DM patients(all P<0.05). The areas under the curve for predicting DR using serum FGF23, ADAM10, and their combination were 0.869, 0.953, and 0.973, respectively. The sensitivities were 90.00%, 95.00%, and 87.50%, and the specificities were 70.00%, 85.00%, and 95.00%, respectively. Conclusion: Serum levels of FGF23 and ADAM10 are closely associated with the occurrence of DR in T2DM patients and serve as independent risk factors. They can assist in the diagnosis of DR in T2DM patients, with combined detection showing superior diagnostic performance.

参考文献：

[1] 万伟伟,龙洋,刘宏卓,等.2型糖尿病患者血浆褪黑素水平与糖尿病视网膜病变的相关性研究[J].眼科新进展,2021,41(5):447-451.
[2] 程坤,谢金凤,唐刚学,等.2型糖尿病患者血清SUA和CysC水平与糖尿病视网膜病变的关系[J].国际眼科杂志,2022,22(11):1867-1871.
[3] 梁堂钰,曾惠红,赖文娟.2型糖尿病患者糖化血红蛋白和空腹血糖水平与视网膜病变的相关性探讨[J].中国医药科学,2019,9(12):181-184.
[4] 杨彩霞,夏利.血清晚期糖基化终末产物和血管内皮生长因子水平与2型糖尿病患者视网膜病变的关系[J].中华实用诊断与治疗杂志,2023,37(7):711-715.
[5] PETRICA L,URSONIU S,GADALEAN F,et al.Urinary podocyte-associated mRNA levels correlate with proximal tubule dysfunction in early diabetic nephropathy of type 2 diabetes mellitus[J].Diabetol Metab Syndr,2017,9:31.
[6] ABU EL-ASRAR A M,NAWAZ M I,AHMAD A,et al.Evaluation of proteoforms of the transmembrane chemokines CXCL16 and CX3CL1,their receptors,and their processing metalloproteinases ADAM10 and ADAM17 in proliferative diabetic retinopathy[J].Front Immunol,2020,11:601639.
[7] NAVARRO-GARCÍA J A,FERNÁNDEZ-VELASCO M,DELGADO C,et al.PTH,vitamin D,and the FGF-23-klotho axis and heart:going beyond the confines of nephrology[J].Eur J Clin Invest,2018,48(4).
[8] DONATE-CORREA J,MARTÍN-NÚÑEZ E,FERRI C,et al.FGF23 and klotho levels are independently associated with diabetic foot syndrome in type 2 diabetes mellitus[J].J Clin Med,2019,8(4):448.
[9] 中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
[10] 中华医学会糖尿病学分会视网膜病变学组.糖尿病视网膜病变防治专家共识[J].中华糖尿病杂志,2018,10(4):241-247.
[11] 杨菲飞,张聪,陈鑫,等.无锡市梁溪区2型糖尿病年发病率变化趋势及预测[J].华南预防医学,2021,47(3):363-366.
[12] WANG G X,FANG Z B,LI J T,et al.The correlation between serum albumin and diabetic retinopathy among people with type 2 diabetes mellitus:NHANES 2011—2020[J].PLoS One,2022,17(6):e0270019.
[13] 莫超艳,杨有强,唐敏,等.2型糖尿病患者血清CTRP9水平与糖尿病视网膜病变的相关性[J].临床和实验医学杂志,2023,22(2):146-149.
[14] LIU Y,LIU Y,DENG J,et al.Fibroblast growth factor in diabetic foot ulcer:progress and therapeutic prospects[J].Front Endocrinol,2021,12:744868.
[15] YEUNG S M H,BAKKER S J L,LAVERMAN G D,et al.Fibroblast growth factor 23 and adverse clinical outcomes in type 2 diabetes:a bitter-sweet symphony[J].Curr Diab Rep,2020,20(10):50.
[16] 潘纯,张光明,弓慧杰.血清CTRP9、TNFR1、FGF23与2型糖尿病患者下肢动脉血管病变的相关性研究[J].标记免疫分析与临床,2021,28(12):2074-2077,2146.
[17] ZHANG J,ZHANG M,ZHAO H,et al.Identification of proliferative diabetic retinopathy-associated genes on the protein-protein interaction network by using heat diffusion algorithm[J].Biochim Biophys Acta Mol Basis Dis,2020,1866(10):165794.
[18] LAM S,SHIU S W,WONG Y,et al.Effect of type 2 diabetes on a disintegrin and metalloprotease 10[J].J Diabetes,2022,14(6):394-400.
[19] 许凌雁,游诗瑶,宁捷.2型糖尿病患者血清Ficolin-3 ADAM10水平与颈动脉粥样硬化的关系[J].河北医学,2022,28(2):254-259.
[20] YAO Y,SUN W,SUN Q,et al.Platelet-derived exosomal microRNA-25-3p inhibits coronary vascular endothelial cell inflammation through Adam10 via the NF-κB signaling pathway in ApoE(-/-) mice[J].Front Immunol,2019,10:2205.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录