Clinical significance of serum insulin-like growth factor-Ⅰ, tumor necrosis factor-α, and vascular endothelial growth factor 165 in patients with diabetic retinopathy / 中华内分泌代谢杂志

ABSTRACT

To determine the associations between expressions of insulin-like growth factor-Ⅰ( IGF-Ⅰ), tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF) 165 in serum, and the occurrence and development of diabetic retinopathy ( DR). A total of 129 patients diagnosed as DM in our hospital between September 2015 and September 2017 were randomly selected in the study, including 58 cases single DM, diabetes with non-proliferative retinopathy group ( 45 cases) and diabetic proliferative retinopathy group ( 26 cases). Meanwhile, 110 healthy examinees during the same period were collected as a normal control group. The severity of retinopathy was judged by fundus photography and fundus fluorescein angiography. Blood glucose, BMI, HbA1C , TC, TG, HDL-C, LDL-C, and VLDL-C were detected in all subjects. Enzyme-linked immunosorbent assay (ELISA) was adopted to detect the serum concentrations of IGF-Ⅰ, TNF-α, and VEGF165. The expressions of serum IGF-Ⅰ, TNF-α, and VEGF in DM patients were significantly higher than those in the control group (all P<0.05). As diabetic retinopathy worsened, the expressions of serum IGF-Ⅰ, TNF-α, and VEGF increased. Pearson correlation analysis showed that serum IGF-Ⅰ was positively correlated with TNF-α, TNF-α, and VEGF165, IGF-Ⅰ, and VEGF165(P<0.05). Logistic regression analysis showed that IGF-Ⅰ and VEGF165 were risk factors for DR (OR = 1.059, 1.165, all P<0.05). The sensitivity, specificity and diagnostic accuracy of IGF-Ⅰ, TNF-α, and VEGF165 were higher than IGF-Ⅰ, TNF-α, and VEGF165 alone(AUC = 0.968, 0.928, 0.792, 0.893, all P<0.05). The expression level of IGF-Ⅰ, TNF-α, and VEGF165 in serum was related to the severity of diabetic retinopathy. The diagnosis of diabetic retinopathy with combined IGF-Ⅰ, TNF-α, and VEGF165 measurements was better than the single index of IGF-Ⅰ, TNF-α, and VEGF165.