Study On The Levels And Correlation Between IAPP And Diabetic Retinopathy In Aqueous Humor Of Type 2 Diabetic Patients

Objective: The purpose of this study was to explore the expression of islet amyloid polypeptide(IAPP)in the aqueous humor of patients with diabetic retinopathy(DR)and its relationship with DR by detecting the aqueous humor of DR patients.At the same time,combined with the auxiliary data of patients,the study evaluated the changes in the condition,providing new ideas and directions for clinical treatment.Methods: This study employed a cross-sectional design.Eighty consecutive patients were selected from January 2022 to December 2022,including 40 patients with type 2diabetes mellitus(T2DM)complicated with diabetic retinopathy as the complication group,20 patients with T2 DM without retinopathy as the diabetes group,and 20 patients undergoing senile cataract surgery as the control group.Each patient provided a sample of aqueous humor for detection to determine the expression levels of IAPP,vascular endothelial growth factor(VEGF),interleukin-6(IL-6),interleukin-8(IL-8),and interleukin-10(IL-10)in the aqueous humor,and conducted comparative analyses.First,the gender,age,eye side,and the duration of diabetes mellitus in the diabetes group were compared to determine whether there were differences among them.Second,the expression levels of IAPP,VEGF,IL-6,IL-8,and IL-10 in the aqueous humor of the three groups of patients were compared,and the complication group was divided into the proliferative diabetic retinopathy(PDR)group and the non-proliferative diabetic retinopathy(NPDR)group according to the degree of proliferation for differential and correlation analyses.NPDR group and diabetes group were compared,and there were statistically significant differences in the detection of IAPP and IL-6(P < 0.05).There was no significant difference in the detection of VEGF,IL-8 and IL-10(P > 0.05).Third,the differences in blood biochemical indicators levels between the three groups of patients were compared,including fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c),total cholesterol(TC),triglycerides(TG),high-density lipoprotein(HDL),lowdensity lipoprotein(LDL),waist circumference,and body mass index(BMI),and correlation analyses were conducted.Fourth,the diagnostic efficacy of IAPP,VEGF,IL-6,IL-8,and IL-10 for diabetic retinopathy were analyzed,and their predictive value was evaluated by ROC curves.Results:1.The gender,age,and eye side of the three groups of patients(complication group,diabetes group,and control group)were compared,and there were no significant differences among them(P>0.05).However,there was a significant difference in the duration of diabetes mellitus between the complication group and the diabetes group(P<0.05).2.The comparison of the detection factors in the aqueous humor of the three groups of patients showed significant differences in IAPP,VEGF,IL-6,and IL-8(P<0.05),but no significant differences in IL-10(P>0.05).In addition,the aqueous humor test results of the three groups were pairwise compared,and there were significant statistical differences in the detection of IAPP,IL-6 and IL-8(P < 0.05).In the detection of VEGF,there were statistically significant differences only between the complication group and the diabetes group,between the complication group and the control group(P < 0.05),but no statistically significant differences between the diabetic group and the control group(P> 0.05).Pairwise comparison showed no significant difference in IL-10 detection(P>0.05).Further comparison of the 27 PDR and 13 NPDR cases in the complication group showed that there were significant differences in VEGF and IL-8(P<0.05),but no significant differences in IAPP,IL-6,and IL-10(P>0.05).In addition,there was a positive correlation between the IAPP level in the aqueous humor of the complication group and IL-6 and IL-8(r=0.654,0.670,P<0.05).NPDR group and diabetes group were compared,and there were significant differences in IAPP and IL-6(P < 0.05),but no significant difference in VEGF,IL-8 and IL-10(P > 0.05).3.The blood biochemical indicators of the three groups of patients were compared,including FBG,Hb A1 c,TC,TG,HDL,LDL,WC,and BMI.The results showed significant differences in FBG,Hb A1 c,BMI,and WC(P<0.05),but no significant differences in TC,TG,HDL,and LDL(P>0.05).In addition,there was a positive correlation between the expression level of IAPP in the aqueous humor and VEGF,IL-6,IL-8,FBG,Hb A1 c,BMI,and WC(r=0.383,0.608,0.714,0.403,0.392,0.253,0.310,P<0.05).The expression level of VEGF was positively correlated with IL-6,IL-8,FBG,and Hb A1c(r=0.372,0.453,0.330,0.281,P<0.05),and the expression level of IL-6 was positively correlated with IL-8 and Hb A1c(r=0.623,0.258,P<0.05),while the expression level of IL-8 was positively correlated with FBG,Hb A1 c,BMI,and WC(r=0.429,0.459,0.223,0.329,P<0.05).In addition,there was a positive correlation between FBG and Hb A1 c,WC(r=0.637,0.317,P<0.05),and a positive correlation between Hb A1 c and WC(r=0.303,P<0.05).Furthermore,there was a positive correlation between TC and HDL,LDL(r=0.267,0.864,P<0.05),and a negative correlation between TG and HDL(r=-0.571,P<0.05),and a positive correlation between BMI and WC(r=0.806,P<0.05).4.According to the ROC curve,the diagnostic efficacy of IAPP,VEGF,IL-6,IL-8,and four indicators combined in the aqueous humor for predicting diabetic retinopathy in type 2 diabetes mellitus was analyzed.The results showed that the area under the curve(AUC)of these indicators were 0.672,0.749,0.874,0.838,and 0.939,respectively.Conclusions: 1.In the aqueous humor of patients with DR,the expression level of IAPP is correlated with the degree of DR,and there is a positive correlation with VEGF,IL-6 and IL-8.I2.In the aqueous humor of patients with DR,the expression of IAPP is more sensitive and superior to IL-6,IL-8 and VEGF,which can be used as an early predictor of DR,and requires further study.3.The expression levels of IAPP,VEGF,IL-6,and IL-8 in the aqueous humor are positively correlated with the blood biochemical indicators of patients,such as FBG and Hb A1 c.4.The ROC curve analysis showed that the detection of IAPP,VEGF,IL-6,IL-8,and their combination can effectively predict diabetic retinopathy in type 2 diabetes mellitus.