Serum fibroblast growth factor 21 levels are correlated with the severity of diabetic retinopathy.

Yuan Lin,Yi Zhang,Yu-Bin Wang,Ma-Li Zheng,Xiang-Hong Lu,Rui-Sheng Zhong,Qing-Yan Xu,Xiu-Juan Li,Zhu-Mei Xu,Xiang-Dong Xu,Lei Qi,Bo-Le Wu,Hong Zhu,Ye-Cheng Xiao

doi:10.1155/2014/929756

Abstract

The aim of the study was to assess serum fibroblast growth factor 21 (FGF21) concentrations in Chinese type 2 diabetic patients with and without retinopathy and to assess the association between FGF21 and the severity of retinopathy. 117 diabetic patients were compared with 68 healthy controls. Fasting blood glucose, serum total cholesterol, serum triglycerides, serum insulin, and serum FGF21 levels were estimated. FGF21 concentrations in the patients were significantly higher than those in control. In the patient group there was a significant positive correlation between FGF21, insulin level, and homeostasis model assessment index. Serum FGF21 concentrations in patients with proliferative diabetic retinopathy or nonproliferative diabetic retinopathy were significantly higher than those in patients without diabetic retinopathy. When the presence of diabetes was defined as the final variable in the conditional logistic regression model with the FGF21 concentration as the continuous variable, FGF21 was significantly involved in the model. This study shows that the increase in serum concentration of FGF21 was associated with the severity of diabetic retinopathy and suggests that FGF21 may play a role in the pathogenesis of diabetic retinopathy and its degree.

Highlights

Diabetes mellitus continues to be a tremendous burden throughout the world and is a significant cause of morbidity and mortality
In vivo treatment with fibroblast growth factor 21 (FGF21) results in the amelioration of glucose and regulates lipid metabolism in both murine and nonhuman primate models of diabetes and obesity [15]. These findings demonstrate that FGF21 plays an important role in the regulation of glucose and lipid metabolism and suggest that FGF21 exhibits the therapeutic characteristic necessary for the effective treatment of diabetes and obesity
The percentage of subjects with macrovascular disease was significantly lower in the no DM group, compared to the no diabetic retinopathy (no DR), nonproliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) groups

Summary

Introduction

Diabetes mellitus continues to be a tremendous burden throughout the world and is a significant cause of morbidity and mortality. Diabetic retinal neovascularization is considered to be a major consequence of retinal ischemia caused by capillary occlusion, and the mechanism of its development is not clear [2, 3]. Diabetic retinopathy progresses from mild nonproliferative abnormalities (characterized by increased vascular permeability) to moderate and severe nonproliferative diabetic retinopathy (NPDR) (characterized by vascular closure) and to proliferative diabetic retinopathy (PDR) (characterized by the growth of new blood vessels on the retina and posterior surface of the vitreous) [4, 5]. Macular edema (characterized by retinal thickening from leaky blood vessels) can be developed at any stage of retinopathy. The new blood vessels of PDR and contraction of all accompanying fibrous tissues can distort the retina and lead to fractional retinal detachment, producing severe and irreversible vision loss [6]

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