AIM: To investigate the relationship between serum levels of oxidation and inflammatory factors in type 2 diabetic patients with retinopathy and its clinical significance.

METHODS: Totally 54 cases of patients with diabetic retinopathy was selected as subjects, including 31 patients with diabetes and non-proliferative retinopathy(NPDR group)and 23 patients with diabetes and proliferative retinopathy(PDR group). Another 30 cases of diabetes patients without DR(DM group)and 30 normal people(NC group)was selected as control. The level of fasting blood glucose(FPG), 2h postprandial blood glucose(2hPG), glycosylated hemoglobin(HbA1c), serum malondialdehyde(MDA)and heme oxygenase -1(HO-1), tumor necrosis factor α(TNF-α)and interleukin-6(IL-6)and C reactive protein(CRP)was detected, and variance test detect the difference between 4 groups, and SNK-Q was used to multiple comparison. Pearson correlation analysis was used to compare the correlation between oxidation markers(MDA and Ho-1)and the level of inflammatory factors(TNF-α, IL-6 and CRP). COX multivariate analysis was used to investigate the risk and protective factors of diabetic retinopathy.

RESULTS: The levels of FPG, 2hPG, HbA1c, MDA, TNF-α, IL-6 and CRP in DM group, PDR group and NPDR group were significantly higher than that in NC group(P<0.05), and HO-1 was lower than that in NC group(P<0.05). The levels of MDA, TNF-α, IL-6 and CRP in PDR group and NPDR group were significantly higher than that in DM group(P<0.05), and HO-1 was significantly lower than that of DM group(P<0.05). MDA and TNF-α in PDR group were significantly higher than that in NPDR group(P<0.05), and HO-1 was lower than that in NPDR group(P<0.05). The level of MDA was positively correlated with the level of TNF-α and CRP(P<0.05), and the level of HO-1 was negative correlated with the level of IL-6, TNF-α and CRP(P<0.05). COX multivariate analysis showed that both MDA and TNF-α were risk factors of retinopathy, and HO-1 was the protective factor of retinopathy.

CONCLUSION: Oxidative stress is closely related to the expression of inflammatory factors in serum of patients with diabetes mellitus, and is an important risk factor of DR, and related indicators can be used as markers for DR diagnosis.