| 王士云,成 雅,武传红,张 娟,高海霞.2型糖尿病干眼症患者泪液IL-6、MMP-9、TGF-β1表达及其临床意义[J].,2024,(9):1672-1677 |
| 2型糖尿病干眼症患者泪液IL-6、MMP-9、TGF-β1表达及其临床意义 |
| Expression and Clinical Significance of Tear IL-6, MMP-9 and TGF-β1 of Patients with Dry Eye in Type 2 Diabetes Mellitus |
| 投稿时间：2024-01-06 修订日期：2024-01-25 |
| DOI：10.13241/j.cnki.pmb.2024.09.014 |
| 中文关键词: 2型糖尿病 干眼症 IL-6 MMP-9 TGF-β1 临床意义 |
| 英文关键词: Type 2 diabetes mellitus Dry eye IL-6 MMP-9 TGF-β1 Clinical significance |
| 基金项目:国家自然科学基金项目（81600908）；江苏省科教能力提升工程江苏省研究型医院（YJXYYJSDW4）；江苏省医学创新中心（CXZX202227） |
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| 中文摘要: |
| 摘要 目的：探讨2型糖尿病（T2DM）合并干眼症（DE）患者泪液白细胞介素-6（IL-6）、基质金属蛋白酶-9（MMP-9）、转化生长因子-β1（TGF-β1）表达及其临床意义。方法：选择2021年5月至2023年10月本院收治的T2DM患者97例，根据是否合并DE分为T2DM组和T2DM合并DE组，另选择同期体检的健康对象45例为对照组。采用酶联免疫吸附法（ELISA）检测三组泪液IL-6、MMP-9、TGF-β1表达水平，比较不同病情严重程度DE患者泪液IL-6、MMP-9、TGF-β1表达水平，采用单因素及多因素Logistics回归分析法分析T2DM并发DE的影响因素，采用受试者工作特征曲线（ROC）分析泪液IL-6、MMP-9、TGF-β1对T2DM并发DE的预测价值。结果：T2DM合并DE组泪液IL-6、MMP-9、TGF-β1表达水平高于T2DM组，T2DM组高于对照组（P＜0.05）。重度组泪液IL-6、MMP-9、TGF-β1表达水平及眼表疾病指数量表（OSDI）评分高于中度组，中度组高于轻度组（P＜0.05）；重度组泪膜破裂时间（BUT）、泪液分泌试验（SIT）低于中度组，中度组低于轻度组（P＜0.05）。单因素分析结果显示，年龄、空腹血糖（FBG）、空腹胰岛素（FINS）、超敏C反应蛋白（hs-CRP）、BUT、SIT、OSDI积分均是T2DM并发DE的影响因素（P＜0.05），多因素分析结果显示，OSDI积分及泪液IL-6、MMP-9、TGF-β1升高是T2DM并发DE的独立危险因素（P＜0.05），BUT、SIT升高是保护因素（P＜0.05）。泪液IL-6、MMP-9、TGF-β1及联合检测预测T2DM并发DE的曲线下面积（AUC）分别为0.815、0.806、0.725和0.905，联合检测的预测价值高于单独检测。结论：T2DM合并DE患者泪液IL-6、MMP-9、TGF-β1表达升高，可引起DE病情加重，三项指标联合检测对T2DM并发DE的风险具有较高的预测价值。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the expression and clinical significance of tear interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9) and transforming growth factor-β1 (TGF-β1) of patients with type 2 diabetes mellitus (T2DM) complicated with dry eye(DE). Methods: A total of 97 patients with T2DM admitted to our hospital from May 2021 to October 2023 were selected and divided into T2DM group and T2DM combined with DE group according to whether DE was combined.In addition,45 healthy subjects who underwent physical examination during the same period were selected as the control group. The expression levels of tear IL-6, MMP-9 and TGF-β1 of the three groups were detected by enzyme-linked immunosorbent assay (ELISA). The expression levels of tear IL-6, MMP-9 and TGF-β1 of DE patients with different disease severity were compared. The influencing factors of T2DM complicated with DE were analyzed by univariate and multivariate Logistics regression analysis. The receiver operating characteristic curve (ROC) was used to analyze the predictive value of tear IL-6, MMP-9 and TGF-β1 for T2DM complicated with DE. Results: The expression levels of IL-6, MMP-9 and TGF-β1 in tears of T2DM combined with DE group were higher than those of T2DM group, and those of T2DM group were higher than those of control group(P<0.05). The expression levels of tear IL-6, MMP-9, TGF-β1 and ocular surface disease index (OSDI ) score in the severe group were higher than those in the moderate group, and those in the moderate group were higher than those in the mild group (P<0.05). The tear film rupture time (BUT) and tear secretion test (SIT) in the severe group were lower than those in the moderate group, and those in the moderate group were lower than those in the mild group(P<0.05). The results of univariate analysis showed that age, fasting blood glucose (FBG), fasting insulin (FINS), high-sensitivity C-reactive protein (hs-CRP), BUT, SIT and OSDI scores were all influencing factors of T2DM complicated with DE(P<0.05), the results of multivariate analysis showed that OSDI score and the increase of tear IL-6, MMP-9 and TGF-β1 were independent risk factors for T2DM complicated with DE(P<0.05), and the increase of BUT and SIT were protective factors(P<0.05). Conclusion: The expression of tear IL-6, MMP-9 and TGF-β1 of T2DM patients with DE is increased, which can aggravate the condition of DE. The combined detection of the three indicators has a high predictive value for the risk of T2DM complicated with DE. |
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