AIM: To analysis clinical significance of the nitric oxide(NO), endothelin-1(ET-1), intercellular adhesion molecule-1(ICAM-1)and vascular endothelial growth factor(VEGF)in diabetic retinopathy(DR).

METHODS: Totally 150 patients with diabetic retinopathy from April 2014 to April 2016 were selected, divided into non-retinopathy group(50 cases)and non-proliferative retinopathy group(50 cases)and the proliferative retinopathy group(50 cases), accordinged to the fluorescein fundus angiography, and 50 healthy volunteers as control group. Four kinds of endothelial function indicators, NO, ET-1, ICAM -1 and VEGF levels, were compared among the four groups.

RESULTS: In PDR group, the levels of the four indicators were highest, then in NDR group, NPDR group, those in the control group was the lowest(all P<0.01). Sensitivity and specificity of VEGF were the best(0.97 and 0.80), the positive/negative predictive value were 0.89/0.94, positive likelihood ratio and negative likelihood ratio were 4.83/0.04, Youden index was 0.76, the ROC curve area was 0.83(P<0.01), the threshold was 237.82 pg/mL. Sensitivity and specificity of ET-1 were the second(0.93 and 0.80), the positive/negative predictive value were 0.93/0.80, positive likelihood ratio and negative likelihood ratio were 4.65/0.09 respectively, Youden index was 0.73, the ROC curve area was 0.74(P<0.01), the threshold was 13.45ng/L. Sensitivity and specificity of NO were 0.86 and 0.40, the positive/negative predictive value were 0.81/0.50, positive likelihood ratio and negative likelihood ratio were 1.45/0.33 respectively, Youden index was 0.27, the ROC curve area was 0.68(P<0.01), the threshold was 59.42μmol/L. Sensitivity and specific of ICAM-1 were 0.87 and 0.36, the positive/negative predictive value were 0.80/0.47, positive likelihood ratio and negative likelihood ratio were 1.35/0.23 respectively, Youden index was 0.23, the ROC curve area was 0.64(P<0.01), the threshold was 250.23μg/L.

CONCLUSION: At early stages of DR, vascular endothelial function has begun to change, in which VEGF and ET-1 has an important reference value for the early diagnosis of DR.