Pigment Epithelium Derived-factor、Interleukin-6in The Mechanism Of Type2Diabetic Retinopathy And Rosuvastatin Intervention

Objective:To investigate the role of the serum concentrations of pigment epithelium derived-factor(PEDF),interleukin-6(IL-6) in diabetic retinopathy(DR). To observe the effect of rosuvastatin intervention on the diabetic retinopathy.To investigate the role of rosuvastatin in the improvement of diabetic retinopathy.Methods:(1)Selected125pitients with type2diabetes from September2012to September2013, endocrine out-patient clinic and the inpatient department, Jingzhou hospital affiliated tongji medical college of huazhong university of science and technology (in1999WHO diabetes diagnosis and classification standard) for the experimental group. According to fundus examination, the experimental group was divided into non-diabetic retinopathy (NDR,50cases),background diabetic retinopathy(BDR,42cases),proliferative diabetic retinopathy(PDR,33cases).Other30normal persons were as controls(NC). Diabetic retinopathy diagnosis according to the Chinese Medical Association,1987staging of diabetic retinopathy. With no complication in patients with diabetic retinopathy DR value as0, complicated by diabetic retinopathy patients will be quantified as numerical grade lesions, and the value involved in the study.The concentrations of serum PEDF、 IL-6were determined by Enzyme-linked immunosorbent assay and Electrochemiluminescence.Statistical comparisons were performed by single-factor analysis of variance and Linear correlation analysis.(2) Selected60pitients with type2diabetic retinopathy from September2012to September2013.Self-control and inter-group control prospective study was conducted in60cases of patients with diabetic retinopathy who were randomly divided into two groups after three-months long treatments of rosuvastatin(30cases) and blank(30cases, Only hypoglycemic therapy).Two groups of DR patients had normal blood glucose control (Fasting blood glucose <7.0mmol/1,2-hour postprandial blood glucose<11. lmmo1/1). The treatment is3months. Using paired t test,patients before and after treatment were observed in serum PEDF、IL-6、Total cholesterol(TC)、Triglyceride(TG)、Low density lipoprotein(LDL)、High density lipoprotein(HDL) and retinopathy changes.Results:(1) Compared with the control,the level of PEDF and IL-6in the serum of experimental groups were different significantly(F=93.12. P<0.01; F=198.08, P<0.01). The level of PEDF in the serum of the NDR,BDR and PDR reduced significantly, the level of IL-6in the serum of the NDR,BDR and PDR increased significantly.The duration of diabetes of the NDR,BDR and PDR between groups were different significantly,there was increased significantly (F=264.09， P<0.01).The level of PEDF and IL-6in the serum also significantly correlated with the prolongation and severity of DR(r=-0.831, P<0.01; r=0.852. P<0.01),(r=-0.941, P<0.01; r=0.932, P<0.01)(2) The experimental group after three-months long treatments of rosuvastatin,the content of serum IL-6、TC、TG、LDL were decreased significantly compared to the previous,(P<0.01); The content of serum PEDF、HDL were increased significantly compared to the previous (P<0.01); The retinopathy were significantly improved compared to the previous situation (P<0.01).The blank control group were not given rosuvastatin therapy,after three-months,the serum PEDF、IL-6、TC、TG、LDL、HDL levels and retinopathy did not alter significantly, the difference were not statistically significant (P>0.05).The difference between the experimental group before and after treatment(APEDF、△IL-6、△DR、△TC、△TG、△LDL、△HDL) compared to the blank control group were statistically significant (P<0.01). In the experimental group, the difference between the△PEDF、△IL-6and△DR were statistically significant (P<0.01).In the blank control group,the difference between the△PEDF、△IL-6and△DR were not statistically significant (P>0.05)Conclusions:The PEDF and IL-6play an significant role in the development in diabetic retinopathy, when the serum PEDF concentration decreased or the serum IL-6concentration increased promoted the occurrence and development of diabetic retinopathy.Given treatment of rosuvastatin for patients with diabetic retinopathy could reduce the serum concentrations of IL-6, slow decrease the serum concentrations of PEDF, improve retinopathy patients with diabetic retinopathy.