国际眼科纵览 ›› 2025, Vol. 49 ›› Issue (5): 386-392.doi: 10.3760/cma.j.cn115500-20250520-25510

• 综述 • 上一篇    下一篇

成纤维细胞生长因子21在糖尿病视网膜病变发病机制中的作用

田野 窦国睿 王欣 张国恒 陈媛   

  1. 空军军医大学西京医院眼科 全军眼科研究所, 西安 710032
  • 收稿日期:2025-09-02 出版日期:2025-10-22 发布日期:2025-10-16
  • 通讯作者: 陈媛,Email: cyuan115@163.com
  • 基金资助:
    国家自然科学基金(82371071);空军军医大学交叉融合专硕(2024JC019);军队高层次科技创新人才工程自主研究项目(2023RCZZ009);国防生物科技优秀青年人才基金(02-SWKJYCJJ12)

Role of fibroblast growth factor 21 in the pathogenesis of diabetic retinopathy

Tian Ye, Dou Guorui, Wang Xin, Zhang Guoheng, Chen Yuan   

  1. Department of Ophthalmology, Xijing Hospital, The Air Force Medical University,  Eye Institute of PLA, Xi’an 710032, China
  • Received:2025-09-02 Online:2025-10-22 Published:2025-10-16
  • Contact: Chen Yuan, Email: cyuan115@163.com
  • Supported by:
    National Natural Science Foundation of China (82371071); Cross-fusion Special Project of AFMU (2024JC019); Independent Research Projects for Scientific and Technological Innovation Talents of the Military (2023RCZZ009); Outstanding Young Talent Fund for Defense Biotechnology (02-SWKJYCJJ12)

摘要: 糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病的主要微血管并发症,严重威胁患者视功能,其发生与长期的糖脂代谢失衡、高血压和胰岛素抵抗密切相关。成纤维细胞生长因子21(fibroblast growth factor 21,FGF21)作为关键的代谢调节因子,通过特异性激活FGF受体/β-Klotho复合体,不仅可以增强胰岛素敏感性、改善糖脂代谢,还可直接调控视网膜血管内皮细胞功能。值得注意的是,尽管临床DR患者血浆中FGF21水平显著升高,但其病理生理意义仍存争议,可能涉及代偿性保护机制或FGF21抵抗状态。FGF21在DR进展中的作用及可能机制,可能主要通过激活AKT/ERK及Nrf2等信号通路,抑制氧化应激、减轻炎症反应、阻断病理性血管生成、降低血管渗漏,并改善神经视网膜功能。

关键词: 成纤维素样细胞生长因子21, 糖尿病视网膜病变, 分子机制

Abstract: Diabetic retinopathy (DR) is a major microvascular complication of diabetes mellitus, which is a serious threat to patients' visual function, and its occurrence is closely related to the imbalance of glucose and lipid metabolism, hypertension and insulin resistance. Fibroblast growth factor 21 (FGF21), as a key metabolic regulator, not only enhances insulin resistance and improves glucose-lipid metabolism, but also directly regulates the function of retinal vascular endothelial cells through specific activation of the FGF receptor/β-Klotho complex. Notably, despite significantly elevated plasma levels of FGF21 in patients with clinical DR, its pathophysiologic significance remains controversial and may involve compensatory protective mechanisms or FGF21-resistant states.The role and possible mechanisms of FGF21 in the progression of DR may be mainly through the activation of signaling pathways such as AKT/ERK and Nrf2, which inhibit oxidative stress, attenuate the inflammatory response, block pathologic angiogenesis, vascular leakage, and improve neural retinal function.

Key words: Fibroblast growth factor 21, Diabetic retinopathy, Molecular mechanism