摘要
目的探讨2型糖尿病视网膜病变(diabetic retinopathy,DR)患者血清25-羟维生素D[25-hydroxy vitamin D,25-(OH)D]水平及其发生和严重程度的影响因素。方法选取2型糖尿病(type 2 diabetes mellitus,T2DM)300例,根据疾病不同阶段分为无DR糖尿病组、背景期DR组和增殖期DR组3组各100例,另选取健康志愿者100例作为正常对照组。比较所有入选者性别、年龄、糖尿病病程、体质量指数(body mass index,BMI),测定比较血清25-(OH)D和甘油三酯(triacylglycerol,TG)、高密度脂蛋白(high density lipoprotein,HDL)、总胆固醇(total cholesterol,TC)、糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)水平。采用Pearson相关性分析对T2DM患者临床及实验室指标与DR的相关性进行分析,应用多因素Logistic回归分析对2型DR发生和严重程度的影响因素进行分析。结果4组糖尿病病程和血清25-(OH)D、HbA1c水平总体比较差异有统计学意义(P<0.01)。随着DR进展,正常对照组、无DR糖尿病组、背景期DR组和增殖期DR组4组糖尿病病程逐渐延长,血清25-(OH)D水平逐渐下降,HbA1c水平逐渐升高,两两比较差异均有统计学意义(P<0.01)。Pearson相关性分析结果显示,T2DM患者糖尿病病程及HbA1c水平与DR呈正相关(P<0.01),血清25-(OH)D水平与DR呈负相关(P<0.01)。多因素Logistic回归分析结果显示,病程和HbA1c是2型DR发生的危险因素(P<0.05),而血清25-(OH)D是2型DR发生的保护因素(P<0.01);血清25-(OH)D是2型DR严重程度的保护因素(P<0.01)。结论T2DM患者血清25-(OH)D水平下降,可能促进了DR的发生和发展,与DR的严重程度相关。
Objective To investigate the level of 25-hydroxyvitamin D[25-(OH)D]in the serum of patients with Type 2 diabetes mellitus(T2DM)combined with diabetic retinopathy(DR)and the factors influencing its occurrence and the degree of severity.Methods Three hundred patients with T2DM were divided into non-DR diabetes group,background DR group and proliferative DR group according to different stages of the disease,with 100 cases in each group.In the meantime,100 healthy volunteers were selected as the control group.All subjects enrolled were compared for sex,age,course of diabetes,body mass index(BMI).The levels of 25-(OH)D and triacylglycerol(TG),high-density lipoprotein(HDL),total cholesterol(TC)and glycosylated hemoglobin A1c(HbA1c)were measured.Pearson's correlation coefficient was used to analyze the correlation of clinical and laboratory findings with DR in patients with T2DM,and multivariate Logistic regression analysis was used to analyze the factors influencing occurrence and the severity of DR in T2DM patients.Results There were statistically significant differences in the course of diabetes and the levels of 25-(OH)D and HbA1c between the four groups(P<0.01).With the progression of DR,the course of diabetes was prolonged in the four groups,the level of 25-(OH)D in serum was decreased and the level of HbA1c was increased gradually.There was a statistically significant difference between every two factors(P<0.01).Results of Pearson's correlation coefficient showed that the course of diabetes and the level of HbA1c were positively correlated with DR(P<0.01),and the level of 25-(OH)D was negatively correlated with DR(P<0.01).Results of multiple Logistic regression analysis showed that course of disease and HbA1c were the risk factors of DR in T2DM patients(P<0.05),serum 25-(OH)D was the protective factor of DR in T2DM patients(P<0.01),and serum 25-(OH)D was the protective factor of severity of DR in T2DM patients(P<0.01).Conclusion The decrease of 25-(OH)D level in T2DM patients may promote the occurrence and development of DR,and it is related to the severity of DR.
作者
关清华
程岚
赵兴
马小羽
姚辉
旷劲松
GUAN Qing-hua;CHENG Lan;ZHAO Xing;MA Xiao-yu;YAO Hui;KUANG Jin-song(Department of Endocrinology,the Fourth People's Hospital of Shenyang,Shenyang 110031,China;Department of Ophthalmology,Liaoning Provincial Corps Hospital of Chinese People's Armed Police Forces,Shenyang 110034,China;Department of Geriatric Endocrinology,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)
出处
《临床误诊误治》
2021年第1期98-102,共5页
Clinical Misdiagnosis & Mistherapy
基金
国家自然科学基金项目(81600693)。
