Diyabetik retinopatide serum ve aköz humorde YKL-40 düzeylerinin değerlendirilmesi
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Tarih
2022
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Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Diyabetik retinopati (DR) patofizyolojisinde, kronik inflamasyon, hipoksi ve iskemi sonucu proinflamatuar ve anjiyogenik mediatörlerin salınımı önemli rol oynar. Bu mediatörler vasküler endotelyal hücre disfonksiyonu ve proliferasyonu tetikleyerek DR şiddetinin ilerlemesine neden olur. Diyabetes mellitusun (DM) yeni potansiyel biyobelirteci olarak kabul edilen YKL-40 (kitinaz-3 benzeri protein 1), hipoksik, iskemik ve inflamatuar durumlarda yükselen, endotelyal disfonksiyonda ve anjiyogenezde rol oynadığı gösterilen bir glikoproteindir. Çalışmamızda tip 2 DM hastalarının serum ve aköz örneklerinde YKL-40 miktarlarının tespit edilmesi ve DR şiddetindeki etkisinin araştırılması amaçlanmıştır. Yöntem: Çalışmamıza, 23 kişi kontrol, 26 kişi non-DRP, 21 kişi NPDR ve 20 kişi PDR grubunu oluşturan toplam 90 gönüllü dahil edildi. Katılımcıların HbA1c, HDL, LDL, total kolesterol, trigliserit, CRP, fibrinojen değerleri ile serum ve ön kamaradaki YKL-40 düzeyleri çalışıldı. Bulgular: Kontrol grubuna göre, DM hastalarının serum ve aköz YKL-40 seviyeleri daha yüksektir. DR şiddeti ilerledikçe, serum ve aköz YKL-40 düzeyleri artmaktadır. PDR grubunun serum YKL-40 seviyesi, non-DRP grubuna göre daha fazladır (p=0.047). Aköz YKL-40 düzeyleri NPDR grubunda, non-DRP grubuna göre daha yüksektir (p=0.013). PDR grubunun aköz YKL seviyeleri, NPDR grubu ile kıyaslandığında daha yüksek saptanmıştır (p<0.001). ROC analizine göre, non-DRP'den NPDR-PDR'ye geçişte aköz YKL-40'ın eşik değeri 484.5 pg/ml'dir (eğri altındaki alan= 0.83; p<0.001, %65 duyarlılık ve %88 özgüllük). DM süreleri ile aköz YKL-40 değerleri arasında korelasyon bulunmuştur (r=,384 p=0.001). Sonuç: YKL-40, DR şiddetinin ilerlemesinde rol oynayan önemli bir biyobelirteç olabilir. İlerleyen zamanlarda bu biyobelirtece karşı geliştirilecek ajanların DR tedavisinde alternatif olarak kullanılacağı düşünülmektedir.
Background and Aim: The release of proinflammatory and angiogenic mediators as a result of chronic inflammation, hypoxia and ischemia plays an important role in the pathophysiology of diabetic retinopathy (DR). These mediators trigger vascular endothelial cell dysfunction and proliferation, leading to progression of DR severity. YKL-40 (chitinase-3-like protein 1), accepted as a new potential biomarker of DM, is a glycoprotein that is elevated in hypoxic ischemic and inflammatory conditions and has been shown to play a role in endothelial dysfunction and angiogenesis. In our study, it was aimed to determine the amount of YKL-40 in serum and aqueous samples of type 2 DM patients and to investigate its effect on DR severity. Methods: A total of 90 volunteers were included in our study, 23 of whom were in the control group, 26 from the non-DRP group, 21 from the NPDR group, and 20 from the PDR group. HbA1c, HDL, LDL, total cholesterol, triglyceride, CRP, fibrinogen values and serum and anterior chamber YKL-40 levels were studied. Results: According to the control group, serum and aqueous YKL-40 levels are higher in DM patients. As the severity of DR progresses, serum and aqueous YKL-40 levels increase. The serum YKL-40 level of the PDR group is higher than the non-DRP group (p=0.047). Aqueous YKL-40 levels is higher in the NPDR group than in the non-DRP group (p=0.013). The aqueous YKL-40 levels of the PDR group were found to be higher when compared to the NPDR group (p<0.001). According to the ROC analysis, the threshold value of aqueous YKL-40 in the transition from non-DRP to NPDR-PDR is 484.5 pg/ml (area under the curve= 0.83; p<0.001, 65% sensitivity and 88% specificity). A correlation was found between DM durations and aqueous YKL-40 values (r=.384 p=0.001). Conclusion: YKL-40 may be an important biomarker that plays a role in the progression of DR severity. In the future, agents to be developed against this biomarker can be used as an alternative in the treatment of DR.
Background and Aim: The release of proinflammatory and angiogenic mediators as a result of chronic inflammation, hypoxia and ischemia plays an important role in the pathophysiology of diabetic retinopathy (DR). These mediators trigger vascular endothelial cell dysfunction and proliferation, leading to progression of DR severity. YKL-40 (chitinase-3-like protein 1), accepted as a new potential biomarker of DM, is a glycoprotein that is elevated in hypoxic ischemic and inflammatory conditions and has been shown to play a role in endothelial dysfunction and angiogenesis. In our study, it was aimed to determine the amount of YKL-40 in serum and aqueous samples of type 2 DM patients and to investigate its effect on DR severity. Methods: A total of 90 volunteers were included in our study, 23 of whom were in the control group, 26 from the non-DRP group, 21 from the NPDR group, and 20 from the PDR group. HbA1c, HDL, LDL, total cholesterol, triglyceride, CRP, fibrinogen values and serum and anterior chamber YKL-40 levels were studied. Results: According to the control group, serum and aqueous YKL-40 levels are higher in DM patients. As the severity of DR progresses, serum and aqueous YKL-40 levels increase. The serum YKL-40 level of the PDR group is higher than the non-DRP group (p=0.047). Aqueous YKL-40 levels is higher in the NPDR group than in the non-DRP group (p=0.013). The aqueous YKL-40 levels of the PDR group were found to be higher when compared to the NPDR group (p<0.001). According to the ROC analysis, the threshold value of aqueous YKL-40 in the transition from non-DRP to NPDR-PDR is 484.5 pg/ml (area under the curve= 0.83; p<0.001, 65% sensitivity and 88% specificity). A correlation was found between DM durations and aqueous YKL-40 values (r=.384 p=0.001). Conclusion: YKL-40 may be an important biomarker that plays a role in the progression of DR severity. In the future, agents to be developed against this biomarker can be used as an alternative in the treatment of DR.
Açıklama
Anahtar Kelimeler
Göz Hastalıkları, Eye Diseases, DR; YKL-40; Kitinaz; Vasküler proliferasyon, DR; YKL-40; Chitinase; Vascular proliferation.
