Changes of Serum Levels of DLL4,TXNIP and Periostin in Patients with Diabetic Retinopathy of Different Degree and Their Clinical Value

ZHANG Fengjiao; SONG Lige; LI Jing; HUO Yajie; KANG Zhiqiang

doi:10.3969/j.issn.1004-437X.2025.17.009

Abstract：Objective To investigate the relationship between the expression of serum Delta-like ligand 4(DLL4),thioredoxin interacting protein(TXNIP)and periostin and the diagnostic value of diabetic retinopathy(DR).Methods The clinical data of 136 patients with type 2 diabetes mellitus(T2DM)from May 2021 to November 2023 were collected for retrospective study.The patients were grouped according to fundus lesions,including 40 T2DM patients(no DR group),45 non-proliferative DR patients(NPDR group)and 51 proliferative DR patients(PDR group).Another 68 healthy subjects(control group)were selected.Serum levels of DLL4,TXNIP,periostin and glucose and lipid metabolism indexes[triacylglycerol(TG),glycated hemoglobin(HbA1c),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FPG),total cholesterol(TC),2-hour postprandial blood glucose(2 h PG),high-density lipoprotein cholesterol(HDL-C)]of the 4 groups were compared,the correlation between serum DLL4,TXNIP,periostin expression and glycolipid metabolism and its diagnostic value was analyzed.Results Serum DLL4,TXNIP,periostin levels in PDR group＞NPDR group＞no DR group＞control group(P＜0.05).In PDR group,FPG,2 h PG,HbA1c,TG,TC,LDL-C＞NPDR group＞no DR group＞control group,HDL-C was on the contrary(P＜0.05).Serum DLL4,TXNIP,periostin were positively correlated with FPG,2 h PG,HbA1c,TG,TC,LDL-C,and negatively correlated with HDL-C(P＜0.05).The area under the curve(AUC)of serum DLL4,TXNIP,and periostin were 0.717,0.735,and 0.714,respectively,and the AUC of the combined diagnosis of DR was 0.913.Conclusion The expression of DLL4,TXNIP and periostin in serum of DR patients with different pathological degree is significantly different,which can be used as markers of the occurrence and severity of DR.