■研究血清生长激素(GH)和胰岛素样生长因子-1(IGF-1)对不同血糖水平的糖尿病(DM)伴肢端肥大症无糖尿病视网膜病变患者脉络膜结构的影响。
■将44例肢端肥大症患者的88只眼分为非糖尿病组(23例,46只眼)和一个糖尿病组(21例,42只眼睛)。还包括44名年龄和性别匹配的健康对照和21名无糖尿病性视网膜病变的2型DM患者。使用简单斜率分析的线性回归模型来确定内分泌参数与脉络膜厚度(ChT)之间的相关性和相互作用,脉络膜总面积(TCA),管腔面积(LA),基质面积(SA),脉络膜血管指数(CVI)。
■我们的研究表明,ChT显著增加,洛杉矶,SA,与健康对照组相比,肢端肥大症患者的TCA,CVI没有区别。相对而言,伴有肢端肥大症的DM患者的ChT高于2型DM患者,其他脉络膜参数无显著差异。SA的增强,由肢端肥大症引起的LA和TCA在糖尿病患者中消失,而ChT和CVI不受相互作用的影响。在糖尿病肢端肥大症中,较高的IGF-1(P=0.006)和GH水平(P=0.049),DM持续时间较长(P=0.007),降低血糖(P=0.001),GH和血糖之间的相互作用与增厚的ChT独立相关。较高的GH水平(P=0.016,0.004和0.007),DM持续时间更长(P=0.022、0.013和0.013),降低血糖(P=0.034,0.011和0.01),IGF-1和血糖的相互作用独立地与较大的SA相关,洛杉矶,和TCA。随着血糖水平的升高,血清GH水平与ChT呈正相关,当血糖超过7.35mM/L时,变得微不足道。血清IGF-1水平与LA,SA,TCA变得越来越消极,与LA,仅当血糖水平超过8.59mM/L时,才与GH水平显着负相关。
■在DM存在下,与肢端肥大症相关的脉络膜增强减弱。在糖尿病肢端肥大症中,血糖水平与脉络膜指标的变化及其与GH和IGF-1的关联呈负相关.
■我们揭示了IGF-1和GH对血糖控制相对良好的DM患者脉络膜结构测量的潜在有益影响,这可能为糖尿病视网膜病变提供潜在的治疗靶点。
UNASSIGNED: To examine the effects of serum growth hormone (GH) and insulin-like growth factor-1 (IGF-1) on choroidal structures with different blood glucose levels in patients with diabetes mellitus (DM) with acromegaly without diabetic retinopathy.
UNASSIGNED: Eighty-eight eyes of 44 patients with acromegaly were divided into a nondiabetic group (23 patients, 46 eyes) and a diabetic group (21 patients, 42 eyes). Forty-four age- and sex-matched healthy controls and 21 patients with type 2 DM without diabetic retinopathy were also included. Linear regression models with a simple slope analysis were used to identify the correlation and interaction between endocrine parameters and choroidal thickness (ChT), total choroidal area (TCA), luminal area (LA), stromal area (SA), and choroidal vascular index (CVI).
UNASSIGNED: Our study revealed significant increases in the ChT, LA, SA, and TCA in patients with acromegaly compared with healthy controls, with no difference in the CVI. Comparatively, patients with DM with acromegaly had greater ChT than matched patients with type 2 DM, with no significant differences in other choroidal parameters. The enhancement of SA, LA and TCA caused by an acromegalic status disappeared in patients with diabetic status, whereas ChT and CVI were not affected by the interaction. In the diabetic acromegaly, higher IGF-1 (P = 0.006) and GH levels (P = 0.049), longer DM duration (P = 0.007), lower blood glucose (P = 0.001), and the interaction between GH and blood glucose were associated independently with thicker ChT. Higher GH levels (P = 0.016, 0.004 and 0.007), longer DM duration (P = 0.022, 0.013 and 0.013), lower blood glucose (P = 0.034, 0.011 and 0.01), and the interaction of IGF-1 and blood glucose were associated independently with larger SA, LA, and TCA. As blood glucose levels increased, the positive correlation between serum GH level and ChT diminished, and became insignificant when blood glucose was more than 7.35 mM/L. The associations between serum IGF-1 levels and LA, SA, and TCA became increasingly negative, with LA, becoming significantly and negatively associated to the GH levels only when blood glucose levels were more than 8.59 mM/L.
UNASSIGNED: Acromegaly-related choroidal enhancements diminish in the presence of DM. In diabetic acromegaly, blood glucose levels are linked negatively with changes in choroidal metrics and their association with GH and IGF-1.
UNASSIGNED: We revealed the potential beneficial impacts of IGF-1 and GH on structural measures of the choroid in patients with DM at relatively well-controlled blood glucose level, which could provide a potential treatment target for diabetic retinopathy.