| Purpose: Endothelin-1(ET-1) is one of the most potentendogenous vasoactive peptide identified so far, which can induce persistentvasoconstriction and promote cell mitotic. Our purpose of this experiment is toexplore the role of ET-1in the pathogenesis of proliferative diabetic retinopathy(PDR); and the correlation between the concentration of ET-1respectively withglycosylated hemoglobin (HbA1c), blood glucose, blood lipid by quantitativedetected the expression of ET-1in serum and vitreous and to analyse thepossible risk factors in the occurrence of PDR, so as to provide a new methodof prevention and treatment of PDR. Methods: This experiment enrolled65cases71eyes, who candidated for20gauge standard pars plana vitrectomy. ThePDR group was contained by46cases51eyes, including17males19eyes and29females32eyes,20eyes vitreous hemorrhage without retinal detachment,21eyes retinal detachment with vitreous bleeding and10eyes retinaldetachment without vitreous hemorrhage, and the average age of them was55.82-year-old. The control group was contained by19cases20eyes patientswho were without diabetic, including6males6eyes and13females14eyes,12eyes with rhegmatogenous retinal detachment,8eyes with full thicknessmacular hole (FTMH) and the average age of them was52.70-year-old.Recording all patients’ age, gender, height, weight, case history, random bloodglucose, fasting blood glucose, high density lipoprotein, low density lipoprotein,triglyceride, total cholesterol and duration of diabetes,and the duration ofdiabetes and glycosylated hemoglobin of the PDR patients. All the serum andvitreous samples were collected and centrifugated, then frozened at-80℃ultralow temperature freezer until using. The concentrations of ET-1in serum andvitreous were detected by enzyme-linked immunosorbent assay (ELISA). Allthe obtained data was analyzed by the test of normality. The data expressedwith the mean±standard deviation (ˉx±s), which met normal distribution, using T test of two independent samples mean to copmpare the difference of the twosamples mean. The data which didn’t meet normal distribution expressed withthe median and four percentile interval [M(QL, QU)], analysed by twoindependent samples Wilcoxon test (Z test). The significance level set at P<0.05.Results: The difference of age and gender between the PDR group and thecontrol group weren’t statistically significant (P>0.05), which meant the twogroups have great comparability. The serum concentration of ET-1was1.82(1.16,2.50)pg/ml in the PDR group,which was significantly higher than thecontrol group,in which it was1.21(0.66,1.79)pg/ml, and the difference wasstatistically significant (P=0.007). The vitreous concentration of ET-1was5.27(4.03,6.95)pg/ml in the PDR group, which was significantly higher thanthe control group,in which it was4.19(1.77,5.81)pg/ml, and the difference wasstatistically significant (P=0.013). Although the concentration of ET-1invitreous was significantly higher than in the serum in the two groups, there wasno correlations between the vitreous and the serum in the two groups (r=0.423,P=0.075in the PDR group and r=-0.19, P=0.601in the control group). Thefasting blood glucose (FBG) in the PDR group was6.39(4.88,8.02), whichwas higher than that in control group4.89(4.65,5.10), and the difference wasstatistically significant (P=0.000). The BMI (body mass index) in the PDRgroup was higher than that in control group, and the difference was statisticallysignificant (P=0.031). The glycosylated hemoglobin in the PDR groupincreased and the difference was statistically significant (P=0.000); Comparedwith the high density lipoprotein, low density lipoprotein, triglyceride and totalcholesterol of the two groups, no statistically significant difference was found.Compared with the difference between the PDR patients which were groupedby with or without hypertension, or by with or without vitreous hemorrhage, orby with or without retinal detachment, or by with or without retinal laserphotocoagulation before vitrectomy. It was just found that the serumconcentration of ET-1in the PDR without vitreous hemorrhage group patients was significantly higher than the PDR with vitreous hemorrhage group patients.There were no statistically significant difference of the ET-1concentration invitreous and serum at rest of the data. Conclusion: The concentration of ET-1inthe serum and vitreous of the PDR patient is significant higher than that innormal people, so detecting the concentration of concentration ET-1levels canscreen PDR quickly; The concentration of ET-1is not affected by hypertension,retinal detachment, preoperative panretinal photocoagulation in the PDRpatients; Elevated fasting blood glucose and poorly controlled blood glycaemiaare risk factors for occurrence of PDR. PDR may occur in diabetic patients withnormal blood lipid and BMI. |
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