ABSTRACT
Background@#Fatty acid-binding protein 4 (FABP4) has been demonstrated to be a predictor of early diabetic nephropathy. However, little is known about the relationship between FABP4 and diabetic retinopathy (DR). This study explored the value of FABP4 as a biomarker of DR in patients with type 2 diabetes mellitus (T2DM). @*Methods@#A total of 238 subjects were enrolled, including 20 healthy controls and 218 T2DM patients. Serum FABP4 levels were measured using a sandwich enzyme-linked immunosorbent assay. The grade of DR was determined using fundus fluorescence angiography. Based on the international classification of DR, all T2DM patients were classified into the following three subgroups: non-DR group, non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group. Multivariate logistic regression analyses were employed to assess the correlation between FABP4 levels and DR severity. @*Results@#FABP4 correlated positively with DR severity (r=0.225, P=0.001). Receiver operating characteristic curve analysis was used to assess the diagnostic potential of FABP4 in identifying DR, with an area under the curve of 0.624 (37% sensitivity, 83.6% specificity) and an optimum cut-off value of 76.4 μg/L. Multivariate logistic regression model including FABP4 as a categorized binary variable using the cut-off value of 76.4 μg/L showed that the concentration of FABP4 above the cut-off value increased the risk of NPDR (odds ratio [OR], 3.231; 95% confidence interval [CI], 1.574 to 6.632; P=0.001) and PDR (OR, 3.689; 95% CI, 1.306 to 10.424; P=0.014). @*Conclusion@#FABP4 may be used as a serum biomarker for the diagnosis of DR.
ABSTRACT
Based on the classification dorsal horn evoked by graded stimulation of the sural and gastrocemuis nerves, the convergence of cutaneous and muscular afferents on the neurons was further studied in rat. The results indicate that the dorsal horn neurons activated by stimulating homo-nerve could be classified into three group A, A-C, C. Most of them are A-C.(activated by skin nerve: 68%; by muscular nerve 50.40%). According to their responses to A and C afferents the 125 cutaneo-muscular convergent neurons could be further divided into five groups: 1. A-A 2. A-AC 3. AC-A4. AC-AC 5. C-C. The AC-AC and A-A neurons are much more than the other three(46.27% and 26.12%). The results suggest that the convergent patterns may be involved in the basis for skin and muscle afferents to modulate their imputs(especially pain) in the spinal cord. It might be concerned to the analgesia and hyperalgesia in the level of Spinal cord.