The Research Of The Expression Of Angiopoietin-like 4 In Serum And Vitreous In Proliferative Diabetic Retinopathy

Objective: By means of testing the level of ANGPTL4 in serum and vitreous of patients with proliferative diabetic retinopathy,we explore and analyze the correlation between the concentration of ANGPTL4 respectively with glycosylated hemoglobin,blood lipid,blood glucose,and the risk factors of PDR.ANGPTL4 may play a role in the pathogenesis of PDR.Method: 69 patients(69 eyes)underwent 20 G standard vitrectomy via pars plana of ciliary were chosen as observation subjects.Among them,the PDR group was contained by 49 cases 49 eyes,the average age was 53.49 years old,including 17 females 17 eyes and 32 males 32 eyes,14 eyes vitreous hemorrhage without retinal detachment,30 eyes vitreous hemorrhage simultaneously with retinal detachment,5 eyes retinal detachment without vitreous hemorrhage.The control group was contained by 20 cases 20 eyes who were all without diabetes,the average age was 57.95 years old,including 13 females 13 eyes and 7 males 7eyes,16 eyes with full thickness macular hole,4 eyes with rhegmatogenous retinal detachment.Collecting data of all observation subjects such as age,gender,height,weight,duration of diabetes and therapeutic methods,duration of hypertension,preoperative intraocular pressure and uric acid,fasting blood glucose,total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol,moreover,glycosylated hemoglobin of PDR patients. Enzyme-linked immunosorbent assay(ELISA) was used to test the concentration of ANGPTL4 of samples in serum and vitreous which were collected and centrifuged previously. All the obtained data was analyzed by the test of normality, analysis of variance, Pearson correlation analysis and T test of SPSS17.0 statistics software. The significance level set at P?0.05. Result: 1. The PDR group patients' serum concentration of ANGPTL4(30.761�2.996ng/ml) was lower than the control group significantly(35.912�1.763ng/ml)(t=-8.851, P=0.000); the concentration in vitreous(14.723�1.324ng/ml) was higher than the control group significantly(7.892�0.812ng/ml)(t=24.642, P=0.000). In the two groups, it all showed that the concentration of ANGPTL4 in serum was higher than in vitreous significantly(t=58.401, P=0.000 in PDR group; t=103.01, P=0.000 in the control group). The correlation analysis between the concentration of ANGPTL4 in serum and vitreous of two groups were all positive(r=0.881, P=0.000 in PDR group; r=0.884, P=0.000 in the control group); 2.Comparing body mass index, intraocular pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol and blood pressure of two groups, no statistically significant difference was found(P>0.05). The concentration of fasting blood glucose, creatinine, uric acid in PDR group were higher than those in the control group(P<0.05). 3. It showed positive correlation between ANGPTL4 of serum and triglyceride in the PDR group(r=0.735,P=0.000), negative correlation between ANGPTL4 in serum and high density lipoprotein cholesterol(r=-0.597, P=0.000), therefore, no correlations showed among age, duration of diabetes, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, glycosylated hemoglobin, creatinine, uric Acid and ANGPTL4 in serum or vitreous; 4. It was showed that the concentration of fasting blood glucose and total cholesterol in PDR group with vitreous hemorrhage were higher significantly than those without vitreous hemorrhage(P=0.006 and P=0.022 respectively); 5.It was just found that the level of ANGPTL4 in serum of PDR patient with adiposity was significantly higher than those without adiposity. There were no statistically significant difference of the ANGPTL4 concentration in serum and vitreous at the rest of the data. Conclusion: The concentration of ANGPTL4 in vitreous of PDR patient is significantly higher than normal people, and it may play a role in the angiogenesis of PDR. Therefore, testing the concentration of ANGPTL4 in vitreous can screen the existence of PDR quickly, so as to provide a new method of prevention and treatment of PDR. It showed positive correlation between ANGPTL4 of serum and triglyceride, suggesting it may participate in the pathophysiology of obesity and metabolic syndrome. Elevated fasting blood glucose and poorly controlled blood glycaemia are risk factors for occurrence of PDR.