The Expression And Significance Of LRG1 And TGF-?1 In Serum And Vitreous Of Proliferative Diabetic Retinopathy

BackgroundsDiabetic retinopathy(DR)is the most common microvascular complication that affects the visual acuity of diabetic patients and the most important cause of preventable blindness in the working age population,the incidence of retinopathy in diabetic patients with a course of more than 10 years is more than 50%.According to the severity,DR is divided into the early stage and the late stage,proliferative diabetic retinopathy(PDR)is in its advanced stage and seriously affects the visual acuity of diabetic patients.DR is considered to be blinding eye disease currently.To date,the pathogenesis of DR has not been fully elucidated.Leucine-rich-?2-glycoprotein 1(LRG1)is a newly discovered proangiogenic factor in recent years,it is a secreted glycoprotein and mainly involve in cell migration and cell adhesion,cell migration and apoptosis.It has been found that it is significantly increased in the retinal neovascularization model and associated with endothelial dysfunction in diabetic patients.Transforming growth factor-?1(TGF-?1)is a multi-functional growth factor.Previous studies have shown that this factor is closely related to the occurrence and development of diabetic retinopathy.In vivo and vitro experiments have shown that LRG1 in the retina regulates mitogenic and neovascularization of endothelial cells by modulating TGF-?1 signaling.At present,the domestic research on LRG1 mainly focuses on its tumor neovascularization.This article aims to explore the expression level and significance of LRG1 and TGF-?1 in serum and vitreous of proliferative diabetic retinal and to provide new ideas for the diagnosis and treatment of PDR.objectiveBy quantitatively detecting the changes in serum and vitreous body levels of LRG1 and TGF-?1 in patients with proliferative diabetic retinopathy and analyzing their relevance,we try to explore a new basis for the prevention and treatment of PDR.Methods65 patients(65 eyes)undergoing vitrectomy in our department were selected from January 2017 to December 2017.Among them,36 patients(36 eyes)with proliferative diabetic retinopathy(the PDR group),17 males and 19 females.29 cases(29 eyes)with idiopathic macular hole(IMH)were acted as the controls,including 9 males and 20 females.The fasted venous blood(cubic veins,approximately 3 ml)was collected from the first day of admission.After centrifugation at 3000 rpm for 10 min at 4?,the supernatant was collected and stored in a cryogenic refrigerator for testing.In the 23 G standard triple-channel vitrectomy,approximately 0.2-0.4 ml of undiluted vitreous fluid was collected from all patients without open perfusion.After centrifugation at 3000 rpm for 3 min at 4?,the supernatant was removed and stored in a cryogenic refrigerator for testing.Admissions of the patients were recorded: age,gender,fasting plasma glucose(FPG),HbA1 c,triglyceride(TG),cholesterol(TC),low-density lipoprotein(LDL),high density lipoprotein(HDL),hs-CRP,homocysteine(HCY),angiotensin converting enzyme(ACE).The enzyme-linked immunosorbent assay(ELISA)technique was used to detect the concentrations of LRG1 and TGF-?1 in serum and vitreous fluid samples from PDR and control patients.Organizing the data and performing statistical analysis.Results1.There was no significant difference in gender and age between the PDR group and the control group(P>0.05).FPG,HbAlc,cholesterol(TC),triglyceride(TG),LDL-C and hs-CRP,HCY,and ACE were significantly increased in the PDR group(P<0.05).High-density lipoprotein(HDL)was significantly lower in the PDR group(P < 0.05).2.The serum and vitreous LRG1 and TGF-?1 in the control group were significantly lower than those in the PDR group(P<0.05).the serum LRG1 and TGF-?1 in the control group was higher than those in vitreous fluid,and the difference was not statistically significant(P>0.05).The vitreous LRG1 in PDR group was higher than those in serum(P>0.05).TGF-?1 in vitreous humor was significantly higher than those in serum.The difference was statistically significant(P < 0.05).3.PDR group: There was a positive correlation between serum and vitreous humoral LRG1,correlation coefficient r=0.210.serum and vitreous fluid TGF-?1 was positively correlated,correlation coefficient r=0.11.serum LRG1 and TGF-?1 were positively correlated,correlation coefficient r= 0.125.positive correlation between LRG1 and TGF-?1 in vitreous humor,correlation coefficient r=0.375.4.Pearson correlation analysis showed that serum LRG1 was positively correlated with duration of diabetes,HbA1 c,LDL,and ACE in the PDR group(r=0.238,0.384,0.257,0.206).serum TGF-?1 and duration of diabetes,HbA1 c,TG,LDL,and hs-CRP(r=0.211,0.451,0.206,0.318,and 0.234)and a negative correlation with HDL(r=-0.230).Conclusions1.The formation of PDR was closely related to the condition of blood glucose,dyslipidemia,inflammatory reaction and RAS system activation.2.LRG1 and TGF-?1 played a certain role in the formation of PDR,and may play an important role in promoting the formation of retinal neovascularization and fibrosis.Overexpression and secretion of LRG1 and TGF-?1 may be one of the occurrence and development of PDR.3.The indicators of LRG1 and TGF-?1 can be used as an auxiliary indicator of the incidence of PDR.