Association of diabetic retinopathy with serum serine protease inhibitors, insulin resistance and glycolipid metabolism

Abstract

Objective To investigate the changes of serum Vaspin levels in patients with type 2 diabetic retinopathy (DR) and to analyze its correlation with glucose metabolism and insulin sensitivity. To further investigate the role of Vaspin in the development of type 2 DR. Methods Seclected the clinical data of 150 patients with type 2 diabetes mellitus diagnosed in the Department of Ophthalmology of Linyi Central Hospital of Shandong from January 2014 to December 2016. The patients were divided into non DR (NDR) group, non proliferative group DR (NPDR) group and proliferative type DR (PDR) group, with 50 cases in each group. Another 50 healthy subjects were chosen as control group at the same time. All patients underwent routine ophthalmologic examination. Age, type 2 diabetes, height, weight, and body mass index (BMI) were recorded. Determination of subjects serum fasting blood glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), cholesterol (TC), triglyceride (TG), high density lipoprotein (HDLC) and low density lipoprotein (LDLC). Enzyme linked immunosorbent assay (ELISA) was used for the determination of Vaspin. The age, height, weight, BMI and serum indexes of the subjects were tested by normal distribution, and expressed by mean±standard(±s)deviation. The mean between groups were compared by single factor analysis of variance. When the difference was statistically significant, they were further compared with each other. The correlation between serum markers and stages was analyzed by univariate correlation analysis, and the multivariate correlation analysis was performed after adjusting for gender, age, and BMI. Results Three DR groups subject age height, weight and BMI were compared, there were no significant differences (F=0.509, 0.343, 0.348, 0.357; P>0.05); the 3 groups of subjects was compared, the difference was statistically significant (F=2.397, P 0.05). By single factor analysis correlation, DR stage were significantly correlated with each serum level (r=0.962, 0.861, 0.862, 0.662, 0.613, -0.965, -0.678, -0.853; P<0.05). Adjusted for gender, age and BMI factors, multivariate analysis, DR stage were significantly correlated with HbA1c, FBG, FINS, LDLC and HOMA-IR levels (r=0.467, 0.598, 0.658, 0.357, 0.377; P<0.05), and the decline was significantly correlated with serum Vaspin, HOMA-IS and HDLC (r=-0.612, -0.472, -0.367; P<0.05). Was significantly related to DR stage group Vaspin and HDLC, HOMA-IS (r=0.801, 0.715; P<0.05), and negatively correlated with HOMA-IR (r=0.690, P<0.05). Conclusions tudies have shown that the serum levels of Vaspin in diabetic retinopathy patients are significantly lower, which can affect the sensitivity of insulin, and is closely related to abnormal lipid metabolism. The decrease of serum Vaspin level is a risk factor in the pathogenesis of DR, and Vaspin plays an important role in the pathogenesis of DR. Key words: Diabetic retinopathy; Vaspin; Insulin resistance