ABSTRACT
AIM:
To investigate the expression and
clinical significance of
Toll-like receptor 4(TLR4)and
vascular endothelial growth factor A(VEGFA)in the
serum of
patients with
diabetic retinopathy(DR).
METHODS:
A total of 183
patients with
type 2 diabetes mellitus(T2DM)admitted to our
hospital from January 2021 to January 2022 were collected as the study subjects. They were grouped into non
diabetic retinopathy(NDR)group(n=54), proliferative
diabetic retinopathy(PDR)group(n=68)and non proliferative
diabetic retinopathy(NPDR)group(n=61). In the same period, 70
volunteers who underwent
physical examination in our
hospital were randomly stratified according to age and
sex. After discharge, DR
patients were followed up for 1a and grouped into a poor
prognosis group(n=40)and a good
prognosis group(n=89)based on whether they had
visual impairment.
Enzyme-linked immunosorbent assay(
ELISA)was applied to detect the levels of TLR4 and VEGFA in
serum;
Logistic regression was applied to analyze the influencing factors of DR;
receiver operating characteristic(ROC)curve was applied to analyze the clinical value of
serum TLR4 and VEGFA levels in diagnosing DR and predicting
prognosis.
RESULTS:
There were statistical significance in TLR4 and VEGFA levels among the
control group, NDR group, PDR group, and NPDR group(F=935.753, 516.936, all P<0.05), and further pairwise comparisons showed statistical significance(P<0.05); the expression levels of TLR4 and VEGFA in the
serum of
patients with poor
prognosis were higher than those of
patients with good
prognosis(P<0.01); the results of
Logistic regression analysis showed that TLR4, VEGFA,
course of
disease, and HbA1c were all
risk factors for the occurrence of DR(P<0.05); the ROC results showed that the
AUC of
serum TLR4, VEGFA levels, and their combination for predicting DR was 0.869, 0.862, and 0.931, respectively, the
AUC of
serum TLR4, VEGFA levels, and their combined prediction of visual disability in DR
patients was 0.864, 0.863, and 0.938, respectively.
CONCLUSION:
The expression of TLR4 and VEGFA in
serum of DR
patients is up-regulated, and the combined
detection of TLR4 and VEGFA can be used as a potential
indicator to evaluate the occurrence and poor
prognosis of DR.