候选基因多态性与糖尿病视网膜病变相关性的Meta分析

目的 候选基因多态性位点与2型糖尿病患者（type 2 diabetes mellitus，T2DM）的糖尿病视网膜病变（diabetes retinopathy，DR）相关性的Meta分析。设计 Meta分析。研究对象  T2DM的DR候选基因多态性的英文或中文文献。方法 在Pubmed（National Center for Biotechnology Information）、ISI（Web of Kowledge）、Embase和中国知网（China National Knowledge Internet，CNKI）4个数据库中，系统性检索、收集2019年1月1日以前以中文和英文发表的关于色素上皮源性因子（pigment epithelium derived factor，PEDF）、肿瘤坏死因子（tumor necrosis factor-α，TNF-α）和对氧磷酶-1（paraoxonase 1，PON1）三个基因的多态性位点与DR相关性的文献。采用Stata 12.0软件计算合并优势比（pooled odds ratio，pooled OR），分析组间异质性（Pheterogeneity）和发表偏倚（publication bias）。主要指标 OR值、组间异质性，发表偏倚。结果 共13篇研究纳入本Meta分析，包括2729例DR和3420例糖尿病对照。PEDF基因的 rs12948385位点（显性模型：OR=1.371，95%CI：1.072~1.755，P=0.012；等位基因模型：OR=1.266，95%CI：1.028~1.560，P=0.027）和PON1基因的L55M位点（隐性模型：OR=2.998，95%CI：1.282~7.010，P=0.011）与DR相关；TNF-α基因的rs1800629位点与PDR相关（等位基因模型：OR=1.291，95%CI：1.019~1.636，P=0.034）。结论  PEDF基因的 rs12948385位点、PON1基因的L55M位点可能与DR相关；TNF-α基因的rs1800629位点可能与PDR相关。     

Association between sorbitol dehydrogenase gene polymorphisms and type 2 diabetic retinopathy

Diabetic retinopathy (DR) may affect 98% of diabetic patients, but its aetiology is poorly understood. Besides glycaemic exposure, genetic factors likely contribute to the onset of DR. The polyol pathway, including aldose reductase and sorbitol dehydrogenase (SDH), can be activated under hyperglycaemic conditions. In our work we searched for an association between the C-1214G and G-888C polymorphisms of the SDH gene promoter and the occurrence and progression of type 2 DR. Two hundred and fifteen unrelated individuals with type 2 diabetes mellitus (T2DM) were divided into three groups: without DR, with non-proliferative diabetic retinopathy (NPDR) and with proliferative diabetic retinopathy (PDR). Genotypes of the C-1214G (rs2055858) and G-888C (rs3759890) polymorphisms of the SDH gene were determined with DNA from the peripheral blood lymphocytes of patients by restriction fragment length polymorphism and allele-specific PCR, respectively. The genotype distributions were contrasted by the chi(2) test and the significance of the polymorphism was assessed by multiple logistic regression producing odds ratios (ORs) and 95% confidence intervals (CIs). We found an association (OR 1.73, 95% CI 1.06-2.83) between NPDR and the G allele of the G-888C polymorphism. There was no association between NPDR and the other polymorphisms of the SDH gene. No differences were found in the distributions of these polymorphisms between patients with PDR and those with NPDR. A weak association (OR 2.0, 95% CI 1.29-3.07) was found between DR and the G allele of the G-888C polymorphism. Analysis of the combined genotypes (haplotypes) of both polymorphisms revealed associations between the C/G-C/G genotype and NPDR (OR 2.95, 95% CI 1.07-8.13) as well as DR in general (OR 2.91, 95% CI 1.15-7.36). The G-888C polymorphism of the SDH gene may be associated with the onset of DR rather than with its progression, and its effect may be strengthened by the interaction with the C-1214G polymorphism, but this association is rather weak and requires further study.     

Prevalence of diabetic retinopathy in urban and rural India: A systematic review and meta-analysis

A systematic review and meta-analysis were conducted to estimate the prevalence of diabetic retinopathy (DR) in India’s urban and rural areas. Medline, Scopus, and ScienceDirect databases were searched for population-based studies published in English between January 1990 and April 2021, wherein the prevalence of DR among Indian residents with type 2 diabetes mellitus (DM) was reported. A random-effects model was used to estimate the overall, rural, and urban prevalence. Data from 10 eligible studies were aggregated for meta-analysis. The prevalence of DR was 17.44% (95% confidence interval [CI], 14.33–20.55) in urban and 14.00% (95% CI: 9.13–18.86) in rural population (P = 0.24). The overall DR prevalence was 16.10% (95% CI: 13.16–24.32), and the population prevalence was 1.63% [95% CI: 0.94–2.32]. Prevalence of DR in people with diabetes was lower in the age group of 40–49 years [13.57% (95% CI: 7.16–19.98)] than in the age group of 50–59 years [16.72% (95% CI: 12.80–20.64)] and the age group of 60 years and above [16.55% (95% CI: 12.09–21.00)]. Variability in studies was high: urban (I² = 88.90%); rural (I² = 92.14%). Pooled estimates indicate a narrow difference in DR prevalence among people with diabetes in rural and urban India. The fast urbanization and increasing diabetes prevalence in rural areas underscore the need for providing equitable eye care at the bottom of the health pyramid.     

Epidemiology of diabetic retinopathy and macular oedema: a systematic review

AIMS: To systematically review the literature on the prevalence and incidence of diabetic retinopathy (DR) and macular oedema (MO). METHODS: A search of the bibliographic databases (Medline, Embase, CINAHL) was conducted up to October 2001. Selected relevant studies were scrutinized and included in the review. RESULTS: A total of 359 studies were included. The studies were reported in nearly 100 different journals and in over 50 countries. The majority of the studies were US-based, with large studies such as the Wisconsin Epidemiologic Study of Diabetic Retinopathy dominating the literature. The studies were quite dated and highly heterogeneous in nature in terms of patient selection with variable inclusion criteria (age range, gender, diabetes duration and type, ethnicity, comorbidity, and DR status, assessment, and classification). CONCLUSIONS: There are inconsistencies between epidemiological studies, and differences in study methods may contribute to conflicting reports of prevalence and incidence of DR and MO in diabetic populations. As new therapies for DR and its associated complications emerge, the need to capture and monitor new epidemiological data becomes increasingly important to be able to assess the impact and effectiveness of these therapies. Robust, longitudinal capture of patient data is, therefore, essential to evaluate the impact of current practice on the epidemiology of diabetic eye complications.     

Association between myopia and diabetic retinopathy: a review of observational findings and potential mechanisms

A protective, but inconsistent association between myopia and a decreased risk of diabetic retinopathy (DR) has been suggested in several studies. However, it is unclear whether the structural, or the refractive components of myopia; or both, is the main contributor to this protective relationship. This paper provides a comprehensive review of existing evidence on the association between myopia, and its structural (axial length [AL], anterior chamber depth [ACD]) and refractive (lens biometry and corneal curvature [CC]) components, with DR. 11 studies consisting of 7230 subjects from 1960 to April 2012, were reviewed. A longer AL was the only variable associated with a lower risk and severity of DR. Therefore, the available evidence suggests that AL is the main contributor to the protective influence of myopia on DR observed in earlier studies. Further investigations are now needed to determine the mechanisms by which AL protects against DR.     

Prevalence of diabetic retinopathy in Iran: a systematic review and Meta-analysis

AIM: To estimate the overall prevalence of diabetic retinopathy (DR) in Iran by a systematic review and Meta-analysis. METHODS: We conducted a search of all published literature on diabetic patients for the prevalence of DR using Web of Sciences, PubMed, Scopus, Google Scholar, and national electronic databases SID, Magiran, and Iranmedex from their inception until September 2016 with standard keywords. Pooled estimates of the DR prevalence and the corresponding 95% confidence intervals (CI) were calculated using random effects models. RESULTS: Thirty-one studies involving 23 729 patients with type I and II diabetes were included. The publication bias assumption for prevalence of DR was rejected by Begg and Egger tests (P=0.825, P=0.057, respectively). The results of Cochran test and I2 statistics showed considerable heterogeneity for prevalence of DR (Q=1278.21, d.f.=30, P<0.001 and I2=97.7%). The prevalence of DR, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) in Iranian diabetic patients were 41.9% (95% CI: 35.6-48.2), 32.2% (95% CI: 28.7-35.8), and 13.2% (95% CI: 8.3-18.1), respectively. CONCLUSION: The prevalence of DR in Iran appears a little high. NPDR was more common. This study highlights the necessity for DR screening and management in diabetic patients in Iran.     

Prevalence of diabetic retinopathy, proliferative diabetic retinopathy and non-proliferative diabetic retinopathy in Asian T2DM patients: a systematic review and Meta-analysis

AIM: To investigate the pooled prevalence of diabetic retinopathy (DR), proliferative DR (PDR) and nonproliferative DR (NPDR) in Asian type 2 diabetes mellitus (T2DM) patients. METHODS: We performed a systematic search online search using PubMed, EMBASE, Web of Science, the Cochrane Library, and China WeiPu Library to identify eligible studies that reported the prevalence of DR, PDR and NPDR in Asian T2DM patients. Effect size (ES) with 95% confidence interval (CI) was used to evaluate the prevalence of DR, PDR and NPDR in Asian T2DM patients, respectively. RESULTS: There were 41 references and 48 995 T2DM patients involved in this study. The prevalence of DR, PDR, and NPDR was 28%, 6%, and 27% in T2DM patients, respectively; while the prevalence of PDR and NPDR in DR patients was 17% and 83%, respectively. Subgroup analysis showed that prevalence of DR in T2DM patients from Singaporean, Indian, South Korean, Malaysian, Asian, and Chinese was 33%, 42%, 16%, 35%, 21% and 25%, respectively. In T2DM patients with NPDR from Indian, South Korean, Malaysian, Asian, Chinese, higher prevalence was found than that in PDR patients (45% vs 17%, 13% vs 3%, 30% vs 5%, 23% vs 2% and 22% vs 3%), as well as in DR patients (74% vs 26%, 81% vs 19%, 86% vs 14%, 92% vs 8% and 85% vs 15%). The prevalence of PDR in T2DM from India was higher than patients from other locations of Asia, and the same results were also observed in NPDR patients. CONCLUSION: In either T2DM Asian patients or DR patients, NPDR is more common than PDR. Based on our results, we should pay more attention to NPDR screening and management in T2DM patients, and we also recommend suitable interventions to prevent its progression.     

Vitrectomy for diabetic macular edema: a systematic review and meta-analysis

Objective

To systematically review, and perform meta-analysis on, the available data regarding the efficacy of vitrectomy for diabetic macular edema.

Design

Systematic review and meta-analysis of published randomized controlled trial data.

Methods

We searched PubMed and the Cochrane database for randomized, controlled trials investigating vitrectomy for diabetic macular edema. Structural (foveal thickness) and functional (visual acuity) outcomes were used as the primary outcome measures.

Results

Eleven studies met the criteria for inclusion in this review: these studies were heterogenous in their experimental and control interventions, follow-up period, and eligibility criteria. Seven studies compared vitrectomy with the natural history of diabetic maculopathy, with laser, or with intravitreal corticosteroid injection. Four studies compared vitrectomy with internal limiting membrane peeling to vitrectomy alone. One of the latter 4 studies was the only to investigate vitrectomy in patients with vitreomacular traction. Meta-analysis suggests a structural, and possibly functional, superiority of vitrectomy over observation at 6 months. Vitrectomy also appears superior to laser in terms of structural, but not functional, outcomes at 6 months. At 12 months, vitrectomy offers no structural benefit and a trend toward inferior functional outcomes when compared with laser.

Conclusions

There is little evidence to support vitrectomy as an intervention for diabetic macular edema in the absence of epiretinal membrane or vitreomacular traction. Although vitrectomy appears to be superior to laser in its effects on retinal structure at 6 months, no such benefit has been proved at 12 months. Furthermore, there is no evidence to suggest a superiority of vitrectomy over laser in terms of functional outcomes.     

Intravitreal anti-vascular endothelial growth factor versus panretinal LASER photocoagulation for proliferative diabetic retinopathy: a systematic review and meta-analysis

ObjectiveTo systematically review and perform a meta-analysis on the available evidence for anti-vascular endothelial growth factor (anti-VEGF) monotherapy versus panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR).DesignSystematic review and meta-analysisParticipantsRandomized clinical trials included participants ≥18 years old with clinical or angiographic evidence of PDR. Interventions included were anti-VEGF monotherapy and PRP. Excluded studies were those with potentially biased treatment allocation and those offering combination therapies.MethodsThe primary outcome was mean change in best-corrected visual acuity. Secondary outcomes were the proportion of patients developing severe (<6/60) or moderate (6/24–6/60) vision loss, rates of vitrectomy or vitreous hemorrhage, worsening macula edema, and reduced visual field indices.ResultsFive studies of varying quality met the inclusion criteria (n = 632). The anti-VEGF intervention arm had a mean difference of −0.08 logMAR or 4 Early Treatment Diabetic Retinopathy Study (EDTRS) letters gained (p = 0.02) when compared with PRP at 12 months. The difference in rates of vitrectomy and vitreous hemorrhage favoured anti-VEGF over PRP (risk difference [RD] −0.10, p = < 0.001 and RD −0.10, p = 0.003 respectively).ConclusionsThis meta-analysis of the available evidence in patients with early PDR demonstrates a potential benefit for anti-VEGF over PRP alone. However, these benefits must be weighed against the relative costs of treatment and the potential risks of loss to follow-up.     

Effects of lipid-lowering agents on diabetic retinopathy: a Meta-analysis and systematic review

AIM: To clarify this controversy and to provide evidence for application of lipid lowering agents in treatment of diabetic retinopathy (DR). METHODS: We searched the databases of PubMed, Embase and Cochrane Library Central Register of Controlled Trials (CENTRAL) and abstracts from main annual meetings up to January 1, 2017. Google scholar and ClinicalTrials.gov were also searched for unpublished relevant studies. We included randomized controlled trials (RCTs) that studied lipid-lowering agents in type 1 or type 2 diabetes in this Meta-analysis. The primary endpoint was the progression of DR, and the secondary endpoints included vision loss, development of diabetic macular edema (DME) and aggravation of hard exudates. The pooled odds ratios (OR) with corresponding 95% confidence intervals (95%CIs) were calculated. RESULTS: After systemic and manual literature search by two independent investigators, we included 8 RCTs from 7 published articles with 13 454 participants in this Meta-analysis. The results revealed that lipid-lowering drugs were associated with reduced risk in DR progression [OR=0.77 (95%CI: 0.62, 0.96), P=0.02]. Lipid-lowering agents might have protective effect on DME compared to placebo, although the difference was not statistically significant [OR=0.60 (95%CI: 0.34, 1.08), P=0.09]. However, no significant differences in the worsening of vision acuity [OR=0.96 (95%CI: 0.81,1.14), P=0.64] and hard exudates [OR=0.50 (95%CI:0.15, 1.74), P=0.28] were found between the lipid-lowering drugs and the placebo groups. CONCLUSION: In DR patients, lipid-lowering agents show a protective effect on DR progression and might be associated with reduced risk in the development of DME. However, lipid-lowering agents have no effects on vision loss and hard exudates aggravation. Further clinical trials in larger scale are required to confirm the conclusion of this study and thus justify the use of intensive control lipids with anti-lipid agents at the early stages of DR.     

炎症反应及细胞因子与糖尿病视网膜病变

糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病最主要并发症之一,严重影响人类健康及生活质量,其发病机制尚未清楚。有研究表明炎症反应及细胞因子与DR的发生发展密切相关,我们就近年来相关研究进展作以综述。     

眼部IL-8水平与糖尿病视网膜病变关系的Meta分析

目的:通过系统评价和Meta分析,以确定眼部水溶液样本中IL-8水平与糖尿病视网膜病变(DR)之间的关系。方法:检索PubMed、Embase和Web of Science数据库,检索时间为2010-01/2021-06。采用随机效应模型合并结果,通过敏感性分析确定运算结果是否稳定可靠,并且采用亚组分析寻找异质性可能的来源。结果:共纳入25篇病例对照研究。DR患者的IL-8水平明显高于非DR患者(SMD:1.57,95%CI:1.19～1.95,P<0.01)。敏感性分析提示随机效应的运算结果是稳定可靠的。基于检测方法、地区、样本来源、DR类型的亚组分析显示,这些因素的选择在很大程度上会影响IL-8水平与DR患者的关系。其中,来自Bead-based法(I²=18%,P=0.27)、欧洲(I²=38%,P=0.17)和非增殖性糖尿病视网膜病变(NPDR)(I²=0%,P=0.49)样本的一致性比较好。而ELISA、美洲、亚洲、玻璃体液、增殖性糖尿病视网膜病变(PDR)等因素都可能会加大效应量。结论:眼部水溶液中IL...     

促红细胞生成素基因与糖尿病视网膜病变相关性的Meta分析

目的 分析促红细胞生成素（EPO）基因单核苷酸多态性位点（SNP）与继发于2型糖尿病（T2DM）视网膜病变（DR）的相关性。设计Meta分析。研究对象 以英文或中文发表的以探讨DR和EPO基因相关性为研究目的的文献。方法 搜集中国知网（China National Knowledge Internet,CNKI）、Web of Knowledge（ISI）、National Center for Biotechnology Information（Pubmed）和Embase 4个数据库中2020年9月30日以前以中文或英文发表的关于EPO基因与DR相关性的文献。使用Stata 12.0软件进行Meta分析。主要指标 合并优势比（pooled odds ratio,pooled OR）、组间异质性（Pheterogeneity）和发表偏倚（publication bias）。结果 共6篇文献纳入本Meta分析,包括1940例DR和2175例糖尿病对照。结果显示EPO基因的rs507392, rs1617640和rs551238 位点与DR无显著相关性（P均>0.05）。结论 EPO基因可能与DR无相关性。     

糖尿病视网膜病变基因多态性研究现状

糖尿病视网膜病变(DR)是一种与血糖水平、病程长短以及遗传与环境因素相互作用所致的复杂疾病,其相关或易感基因的研究在近年来非常活跃.DR的相关候选基因包括醛糖还原酶基因、血管内皮生长因子基因、血管紧张素转换酶基因、一氧化氮合酶基因、非酶糖基化终末产物受体基因等.DR是多基因作用的疾病,而每个基因存在不同的多态性.准确把握基因在DR发生发展过程中的作用机制及其表达的差异性,对其早期诊断、防治DR的发生发展及开发新的诊疗手段具有重要意义.本文就有关DR相关基因的研究现状及进展进行综述.     

血清可溶性肿瘤坏死因子受体与2型糖尿病视网膜病变相关性研究

目的　研究血清可溶性肿瘤坏死因子受体（ｓｏｌｕｂｌｅｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒｒｅｃｅｐｔｏｒ,ｓＴＮＦＲ）与２型糖尿病视网膜病变的相关性。方法　６６例２型糖尿病患者通过眼底检查和眼底荧光血管造影按照ＥＤＴＲＳ分期分为３组:无糖尿病视网膜病变（ｎｏｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＮＤＲ;ｎ＝２２）组、非增殖型糖尿病视网膜病变（ｎｏｎｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＮＰＤＲ;ｎ＝２４）组和增殖型糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ,ＰＤＲ;ｎ＝２０）组。２１名健康人作为对照组。检测４组研究对象血清中肿瘤坏死因子（ｔｕｍｏｒｎｅｃｒｏｓｉｓｆａｃｔｏｒ,ＴＮＦ）-α、ｓＴＮＦＲ-１、ｓＴＮＦＲ-２水平。组间统计分析采用非参数Ｍａｎｎ-ＷｈｉｔｎｅｙＵ检验。结果　血清中ＴＮＦ-α中位数分别为:对照组０ｐｇ·ｍＬ－１、ＮＤＲ组３．４５ｐｇ·ｍＬ－１、ＮＰＤＲ组３．９２ｐｇ·ｍＬ－１、ＰＤＲ组８．１２ｐｇ·ｍＬ－１。对照组与ＰＤＲ组（Ｐ＜０．００１）、ＮＤＲ组与ＰＤＲ组（Ｐ＝０．００８）比较差异均有统计学意义。血清中ｓＴＮＦＲ-１水平中位数:对照组１．５０ｎｇ·ｍＬ－１、ＮＤＲ组１．８８ｎｇ·ｍＬ－１、ＮＰＤＲ组２．５８ｎｇ·ｍＬ－１、ＰＤＲ组３．００ｎｇ·ｍＬ－１。对照组与ＮＰＤＲ组（Ｐ＜０．００１）、对照组与ＰＤＲ组（Ｐ＜０．００１）、ＮＤＲ组与ＮＰＤＲ组（Ｐ＝０．００７）、ＮＤＲ组与ＰＤＲ组（Ｐ＜０．００１）比较,差异均有统计学意义。血清中ｓＴ-ＮＦＲ-２中位数分别为:对照组３．８８ｎｇ·ｍＬ－１、ＮＤＲ组５．０１ｎｇ·ｍＬ－１、ＮＰＤＲ组５．２１ｎｇ·ｍＬ－１、ＰＤＲ组６．３３ｎｇ·ｍＬ－１。除了ＮＤＲ组与ＮＰＤＲ组（Ｐ＝０．０７０）间差异无统计学意义外,其他组间差异均有统计学意义（均为Ｐ＜０．０５）。结论　血清中ｓＴＮＦＲ与２型糖尿病视网膜病变密切相关,表明ｓＴＮＦＲ在糖尿病视网膜病变的发生发展中起到了一定的作用。对ｓＴＮＦＲ进行进一步研究可以寻找治疗糖尿病视网膜病变新的靶点。     

Computer aided diabetic retinopathy detection based on ophthalmic photography: a systematic review and Meta-analysis

AIM: To ensure the diagnostic value of computer aided techniques in diabetic retinopathy (DR) detection based on ophthalmic photography (OP). METHODS: PubMed, EMBASE, Ei village, IEEE Xplore and Cochrane Library database were searched systematically for literatures about computer aided detection (CAD) in DR detection. The methodological quality of included studies was appraised by the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). Meta-DiSc was utilized and a random effects model was plotted to summarize data from those included studies. Summary receiver operating characteristic curves were selected to estimate the overall test performance. Subgroup analysis was used to identify the efficiency of CAD in detecting DR, exudates (EXs), microaneurysms (MAs) as well as hemorrhages (HMs), and neovascularizations (NVs). Publication bias was analyzed using STATA. RESULTS: Fourteen articles were finally included in this Meta-analysis after literature review. Pooled sensitivity and specificity were 90% (95%CI, 85%-94%) and 90% (95%CI, 80%-96%) respectively for CAD in DR detection. With regard to CAD in EXs detecting, pooled sensitivity, specificity were 89% (95%CI, 88%-90%) and 99% (95%CI, 99%-99%) respectively. In aspect of MAs and HMs detection, pooled sensitivity and specificity of CAD were 42% (95%CI, 41%-44%) and 93% (95%CI, 93%-93%) respectively. Besides, pooled sensitivity and specificity were 94% (95%CI, 89%-97%) and 87% (95%CI, 83%-90%) respectively for CAD in NVs detection. No potential publication bias was observed. CONCLUSION: CAD demonstrates overall high diagnostic accuracy for detecting DR and pathological lesions based on OP. Further prospective clinical trials are needed to prove such effect.     

The relationship of blood cell-associated inflammatory indices and diabetic retinopathy: a Meta-analysis and systematic review

AIM: To explore the correlation between several blood cell-associated inflammatory indices including mean platelet volume (MPV), platelet distribution width (PDW), neutrophil to lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and the presence and severity of diabetic retinopathy (DR). METHODS: We searched for eligible studies from PubMed, EMBASE, Web of Science and CNKI up to December 13, 2017. Standardized mean difference (SMD) calculated with confidence interval (CI) of 95% was used to estimate the values of those indices. RESULTS: A total of 31 studies were included in the present Meta-analysis. As compared with type 2 diabetes mellitus (T2DM) patients without DR, the values of MPV, PDW, NLR, and PLR were higher in patients with DR (SMD=0.67; 95%CI: 0.36 to 0.98; SMD=0.51; 95%CI: 0.27 to 0.75; SMD=0.77; 95%CI: 0.49 to 1.05 and SMD=1.18; 95%CI: 0.07 to 2.28). Additionally, it was also observed that MPV was closely correlated with the severity of DR. CONCLUSION: MPV, PDW, NLR, and PLR could be recommended as diagnostic biomarkers for DR, and MPV could be applied to assess the severity of DR.     

Nrf2基因多态性与糖尿病视网膜病变的相关性研究

目的：探讨陕西地区汉族人群中,核因子E2相关因子2(Nrf2)基因多态性与糖尿病视网膜病变(DR)的相关性。

方法：收集2016-01/2017-01在我院治疗的386例2型糖尿病(T2DM)患者分为无视网膜病变(DWR)组181例,增生期DR(PDR)组62例和非增生期DR(NPDR)组143例。另外,收集120例非糖尿病且无视网膜疾病的患者作为对照组。采用聚合酶链反应(PCR)联合DNA直接测序法检测Nrf2基因启动子rs6721961位点单核苷酸多态性。

结果： DWR组与对照组比较,rs6721961位点基因型和等位基因分布频率均无差异(P>0.05); PDR组和NPDR组分别与对照组和DWR组比较,突变纯合子(AA基因型)和突变基因(A等位基因)分布频率差异均有统计学意义(P<0.05)。PDR组和NPDR组比较,基因型和等位基因分布频率均无差异(P>0.05)。Logistic多因素回归分析结果显示rs6721961位点A等位基因与DR发生相关(OR=1.532, 95%CI ：1.169～2.008, P=0.014)。

结论： Nrf2基因多态性可能与DR遗传易感性相关。     

Association of pseudoexfoliation syndrome with cardiovascular and cerebrovascular disease: a systematic review and meta-analysis

Objective

Pseudoexfoliation syndrome (PEX) is a systemic disease, but evidence of its association with cardiovascular disease (CVD) and cerebrovascular disease (CVA) is controversial. A quantitative systematic review will provide an accurate summary of the current body of the literature.