| Objection: To determine the levels of thrombospondin-1(Tsp-1)in the serum of patients with diabetic retinopathy(DR),and the levels of Tsp-1、 vascular endothelial growth factor(VEGF)、Pigment epithelium-derived factor(PEDF)in the vitreous fluid of patients with proliferative diabetic retinopathy(PDR)and rhegmatogenous retinal detachment(RRD),finding the relationship between changes in serum and vitreous TSP-1 levels and the development of PDR.At the same time to understand the correlation between TSP-1 and VEGF/PEDF,to explore the mechanism of TSP-1 in neovascularization of PDR.Methods: A total of 88 patients with type 2 diabetes in department of ophthalmology and endocrinology of our hospital were selected and divided into 3 groups according to the guidelines for clinical diagnosis and treatment of diabetic retinopathy in China in 2014,they were: non-diabetic retinopathy group(NDR,n=22);non proliferative diabetic retinopathy group(NPDR,n=28);PDR group(PDR,n=38);and the control group were patients who diagnosed as rhegmatogenous retinal detachment(RRD)without diabetes(RRD,n=40).Record the gender,age,height,weight,duration of diabetes,glycosylated hemoglobin(HbA1c)and fasting blood-glucose(FBG)in all group,the enzyme-linked immunosorbent assay(ELISA)was used to determine the content of TSP-1 in the serum of all subjects,and the content of TSP-1,VEGF and PEDF in the vitreous of PDR group and RRD group.Results: 1.There was no significant difference in gender,age,duration of diabetes,and body mass index(P>0.05).The difference between all groups in HbA1 c was significant(PDR>NPDR>NDR>RRD,P<0.01).There was a significant difference in the difference between FBG in all groups(NDR>PDR>NPDR>RRD,P<0.01).2.The serum TSP-1 levels were significantly difference in all groups(RRD>NDR>NPDR>PDR,P<0.01),and the RRD group,NDR group,NPDR group,and PDR group had statistically significant differences in each two groups(P<0.01).The TSP-1 levels,VEGF levels,PEDF levels,and VEGF/PEDF were significantly different in the vitreous of PDR patients than in that of RRD patients(P<0.01).3.In PDR patients,we observed a significant positive correlation between serum TSP-1 and vitreous TSP-1 levels(r=0.76,P<0.05);the vitreous TSP-1 level in PDR patients had a robust negative correlated with the VEGF level(r=-0.58,P<0.05);there was a positive correlation between TSP-1 and PEDF levels in the vitreous of patients with PDR,and the difference was statistically significant(r=0.62,P<0.05);Moreover,a significant.negative correlation between the TSP-1 level and VEGF-to-PEDF ratio was observed in the vitreous of PDR patients(r=-0.79,P<0.05);4.Correlation between TSP-1 and Diabetes Mellitus: In PDR patients,the TSP-1 levels in serum have a positive variation to HbA1c(r=0.37,P<0.05),the result is similar as its’ level in vitreous(r = 0.38,P <0.05).There is no correlation between the TSP-1 both in serum and vitreous with the FBG in the patients with PDR.Conclusion: 1.Serum TSP-1 levels were significantly different at different stages of DR,and vitreous TSP-1 levels were significantly reduced in PDR patients,TSP-1 may be involved in the pathophysiology of DR.2.In the vitreous of PDR patients,TSP-1 levels were negatively correlated with VEGF levels,positively correlated with PEDF levels,and negatively correlated with VEGF/PEDF,TSP-1 may participate in the pathological process of PDR through cooperation with VEGF and PEDF.3.In PDR patients,serum and vitreous TSP-1 levels were positively correlated with HbA1 c levels and had no correlation with FBG. |
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