تاثير مکمل روي بر سطوح سرمي عامل نوروتروفيک مشتق از مغز و عامل رشد اندوتليال عروقي در بيماران مبتلا به رتينوپاتي ديابتي

خلاصه فارسی

هدف: کمبود روی و ساير ريزمغذی ها در بیماران ديابتي شايع است و همچنین از عوارض شايع ديابت، رتینوپاتي ديابت ميباشد. به نظر ميرسد که کمبود روی بر ايجاد و تسريع اين عارضه تاثیر داشته باشد. لذا هدف اين مطالعه ارزيابي اثر مکمل ياری روی بر سطوح سرمي عامل رشد اندوتلیال عروقي، عامل نوروتروفیک مشتق از مغز، شاخصهای ديابت و فشار خون در بیماران مبتلا به رتینوپاتي ديابتي غیر پرولیفراتیو بود. افراد مورد مطالعه و روش اجرا: 45 بیمار مبتلا به رتینوپاتي ديابتي ) 20 مرد و 25 زن( با محدوده سني 40 تا 70 سال در اين مطالعه کارآزمايي بالیني دوسوکور وارد شدند. رتینوپاتي ديابتي توسط يک چشم پزشک ماهر بر اساس معیارهای رتینوپاتي ديابتي تشخیص داده شد. بیماران به گروه مداخله ( 23 نفر) و دارونما ( 22 نفر) تقسیم شدند. افراد دو گروه از لحاظ سن، جنس، نوع و دوز داروهای مصرفي همسان سازی شدند.گروه مداخله روزی يک عدد قرص 30 میلي گرمي گلوکونات روی و گروه دارونما روزی يک عدد قرص 30 میلي گرم مالتوز دکسترين به مدت سه ماه دريافت کردند. انسولین و قند خون ناشتا، شاخص مقاومت انسولیني،HbA1c ، فشار خون سیستولي و دياستولي، سطوح سرمي روی، عامل رشد اندوتلیال عروقي و عامل نوروتروفیک مشتق از مغز قبل و بعد از مداخله در هر دو گروه اندازه گیری شد. دريافت غذايي، فعالیت فیزيکي و سطح استرس افراد مورد مطالعه به ترتیب با استفاده از پرسشنامههای يادآمد 24 ساعته غذايي، پرسشنامه بین المللي فعالیت فیزيکي و پرسشنامه رويدادهای استرس زای زندگي در سه زمان ابتدا، وسط و انتهای مطالعه ارزيابي شدند.

عنوان انگليسی

Effect of zinc supplementation on serum levels of brain-derived neurotrophic factor and vascular endothelial growth factor in patients with diabetic retinopathy

خلاصه انگلیسی

Abstract: Aim: Zinc (Zn) deficiency has been shown to be associated with age-related eye diseases, such as diabetic retinopathy. Blood pressure and glucose are prognostic factors of diabetic retinopathy.The aim of this study was to evaluate the effects of zinc supplementation on diabetes indices, blood pressure serum levels of brain derived neurotrophic factor (BDNF) vascular endothelial growth factor (VEGF)in patients with non-proliferative diabetic retinopathy. Patients and Methods: 45 patients with non-proliferative diabetic retinopathy (20 males and 25 females) aged from 40 to 70 years were participatedin current double-blind randomized placebo-controlled trial. The disease was diagnosed by an expert ophthalmologist according to early photocoagulation and diabetic retinopathy criteria. The patients were assigned to intervention (23 patients) and placebo (n = 22) groups. Both groups were homogenized in term of age, BMI and sex. The groups received zinc (as zinc gluconate; 30 mg) and placebo (maltodextrin; 30 mg) for 3 months, respectively. Fasting insulin, fasting glucose, insulin resistance index (HOMA-IR), hemoglobin A1C (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum zinc, VEGF and BDNF levels were measured before and after the intervention in the both groups. Dietary intake, physical activity and stress were assessed using 24 hour recall, international physical activity level and stressful life events questionnaires respectively in begin, 6 weeks after beginning and end of the study. Results: No significant differences were seen between both groups in term of demographic variables (P>0.05). Dietary intake of macronutrients, energy, stress and physical activity did not change during the study period in both groups (P>0.05). Also inter-groups statistical analysis showed no significant differences between both groups in each assessment time points (P>0.05). Zinc supplementation significantly increased serum zinc (P= 0.004) and decreased serum insulin levels (P= 0.008), fasting blood sugar (FBS) (P= 0.011) and HOMAIR (P= 0.002). 0.002) and SBP (P= 0.017) in the intervention group compared with placebo group. The intervention had no significant effects on DBP, HbA1c, VEGF and BDNF. Conclusion: due to viscous cycle between diabetes and zinc metabolism, the possibility of zinc deficiency increase in diabetics. Zinc deficiency could have remarkable role in the complications of diabetes. The results of current study showed zinc supplementation improve diabetic indices. Due to the positive effects of zinc supplementation on prognostic factors of diabetic retinopathy, It seems complementary therapy with zinc is needed in these patients. However more research is needed.

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