鸢尾素、白脂素联合检测对2型糖尿病患者视网膜病变的诊断预测价值

Diagnostic value of irisin and asprosin in diabetic retinopathy of type 2 diabetes mellitus

目的 观察血清同型鸢尾素、白脂素联合检测对2型糖尿病视网膜病变的预测价值。方法 选取2021年1月至2023年1月在武汉科技大学附属普仁医院和天门市第一人民医院住院确诊为2型糖尿病的159例患者作为研究对象,分为视网膜病变组76例和非视网膜病变组83例。取患者入院次日清晨空腹外周血,检测并比较患者鸢尾素、白脂素等指标,发生视网膜病变的影响因素以多因素Logistic回归进行分析,进行受试者工作特征曲线分析,确定鸢尾素、白脂素指标对视网膜病变的预测价值。结果 视网膜病变组患者血清鸢尾素水平低于非视网膜病变组患者,血清白脂素水平高于非视网膜病变组患者(P<0.05),患者血清鸢尾素、白脂素水平、糖尿病病程、有无吸烟史、有无饮酒史是T2DM患者发生视网膜病变的影响因素,鸢尾素、白脂素联合指标检测对微血管病变的诊断效能(AUC=0.944,敏感度=92.11%,特异度=87.95%,)均高于各单项指标检测。鸢尾素联合白脂素预测DR病变严重程度的诊断效能AUC提高至0.924(0.840~0.972),联合检测高于各单项指标检测。结论 血清鸢尾素、白脂素水平与T2DM患者视网膜病变相关,二者联合检测可以作为2型糖尿病视网膜病变的早期预警指标。

Objective To investigate the diagnostic value of combination of serum irisin and asprosin for diabetic retinopathy(DR)in type 2 diabetes mellitus(T2DM).Methods A total of 159 T2DM patients in Puren Hospital Affiliated to Wuhan University of Science and Technology and the First People’s Hospital of Tianmen in Hunan Province from January 2021 to January 2023 were enrolled in this study.They were divided into DR group(76 cases)and non-DR group(83 cases)based on the performance of DR or not.Peripheral venous blood samples were collected from all patients on the next morning after admission to detect serum irisin,asprosin indexes.Multivariate logistic regression analysis was performed to analyze the influencing factors of DR.Receiver operating characteristic(ROC)curve analysis was used to determine the predictive value of serum irisin and asprosin for DR.Results Patients in DR group had significantly lower serum irisin and significantly higher serum asprosin relative to patients in non-DR group(P<0.05).Serum irisin and asprosin levels,duration of diabetes mellitus,with or without smoking and drinking history were the influencing factors of DR.The diagnostic efficiency of the combined detection of serum irisin and asprosin for microangiopathy was significantly higher than that of any single index(areas under curve[AUC]=0.944,sensitivity=92.11%,specificity=87.95%).Similarly,the AUC for the combination diagnostic efficacy in predicting the severity of DR Lesions increased to 0.924(0.840-0.972),significantly higher than that of any single index.Conclusion The serum levels of irisin and asprosin are related to DR in T2DM patients.The combined detection can be used as a early warning indicator for DR.