| Purpose:To evaluate the lipid metabolism status of the vitreous in proliferative diabetic retinopathy(PDR)and observe the possible effects of anti-vascular endothelial growth factor(anti-VEGF)on PDR patients.Methods:A total of 45 individuals from the Department of Ophthalmology at Qilu Hospital of Shandong University were enrolled between October 2020 and April 2021 and were divided into three groups.19 patients with PDR were included in the PDR group,who underwent pars plana vitrectomy(PPV)only.10 patients with PDR were included in the anti-VEGF group,who received intravitreal injection of Conbercept(or KH902,Lumitin,Chengdu Kang Hong Biotech Co,Ltd.,Sichuan,China)3～7 days prior to PPV surgery(Anti-VEGF Group).16 age-matched and sex-matched patients with idiopathic epimacular membrane or macular hole without diabetes served as the control group.The lipidomic analysis method of liquid chromatography-tandem mass spectrometry(LC-MS/MS)was used to examine intravitreal lipid expression in the vitreous of the three groups of patients.Univariate and multivariate statistical analyses were performed to compare the differences in lipid expression among the three groups of patients.Receiver operating characteristic(ROC)was used to analyze the diagnostic value of differentially expressed lipids in distinguishing PDR from non-diabetic control patients and whether they could be used as biomarkers for PDR.Results:LC-MS/MS analysis revealed similarities and differences in lipid metabolism among the three groups.16 lipid classes and 160 lipid species were detected in all three groups of samples.The total lipid content of PDR group and antiVEGF group was significantly higher than that of control group.Univariate and multivariate statistical analysis showed that compared with the control group,PDR patients without anti-VEGF treatment had significant changes in 6 lipid species(P<0.05),among which triglycerides(TG,52:2),TG(54:4),TG(54:3),diglycerides(DG,36:3)and sphingomyelin(SM,d40:7+hO)increased,phosphoserine(PS,42:8)lower.ROC analysis revealed that four lipids,TG(54:3),TG(54:4),DG(36:3)and SM(d40:7+hO),showed good diagnostic value in distinguishing PDR patients from the controls.Compared with the control group,11 lipid species in the vitreous were significantly increased in PDR patients receiving anti-VEGF treatment(VIP>1.0 and P<0.05),including TG(50:2),TG(50:1),TG(52:4),TG(52:3),144POS_TG(52:2)145POS_TG(52:2),TG(54:5),TG(54:4),TG(54:3),SM(d42:1)and PC(36:5).Conclusion:Compared with the control group,lipid metabolism in the vitreous of PDR patients was aberrant.And anti-VEGF treatment may alter the vitreous lipid profiles.It is suggested that on the basis of anti-VEGF therapy,the lipid management of an individualized intraocular environment should be strengthened in the treatment of diabetic retinopathy,and the strategy for intraocular lipid regulation should be studied in the future. |
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