糖化血红蛋白变异指数与糖尿病视网膜病变严重程度的相关性研究

Association of glycosylated hemoglobin variation index with diabetic retinopathy severity

目的探讨糖化血红蛋白变异指数(hemoglobin glycation index,HGI)与2型糖尿病(type 2 diabetes mellitus,T2DM)视网膜病变、黄斑水肿严重程度的相关性。方法收集T2DM患者294例纳入研究,根据国际眼科学会(2022年)糖尿病视网膜病变诊断标准分为增殖期糖尿病视网膜病变组(proliferative diabetic retinopathy,PDR)、非增殖期糖尿病视网膜病变组(non-proliferative diabetic retinopathy,NPDR)、无微血管病变组(no microangiopathy,NC)。其中DR严重程度:轻度NPDR<中度NPDR<重度NPDR<PDR。根据国际对糖尿病黄斑水肿(diabetic macular edema,DME)的分级标准分为累及中心凹的糖尿病性黄斑水肿组(central involed diabetic macular edema,CI-DME)、未累及中心凹的糖尿病性黄斑水肿组(non-central involed diabetic macular edema,NCI-DME)、无糖尿病性黄斑水肿组(no macular edema,NDME)。其中DME严重程度:NCI-DME<CI-DME。采集一般临床资料,计算并分析HGI在各组之间的差异。结果NPDR组、PDR组HGI显著高于NC组,且PDR组HGI高于NPDR组。NCI-DME组、CI-DME组HGI显著高于NDME组,且CI-DME组HGI高于NCI-DME组。单因素Logistic回归分析结果显示,糖尿病病程(P<0.01)、体质量指数(P=0.01)、舒张压(P=0.04)、HGI(P=0.01)、空腹血糖(P=0.04)、HbA1c(P=0.01)与T2DM患者发生糖尿病视网膜病变(diabetic retinopathy,DR)差异有统计学意义;HGI与DR严重程度差异有统计学意义(P<0.001)。结论HGI与DR、DME的严重程度密切相关。

Objective This study investigated the correlation between hemoglobin variation index(HGI)and the severity of retinopathy and macular edema in patients with type 2 diabetes mellitus(T2DM).Methods A total of 294 T2DM patients were enrolled.Based on the 2022 International Academy of Ophthalmology diagnostic criteria for diabetic retinopathy(DR),patients were classified into:proliferative DR(PDR),non-PDR(NPDR),and no microangiopathy(NC).DR severity was further categorized as mild NPDR,moderate NPDR,severe NPDR,and PDR.According to the international grading standards for diabetic macular edema(DME),patients were categorized as:central involved DME(CI-DME),non-central involved DME(NCI-DME),and no central involved DME(NDME).DME severity:NCI-DME<CI-DME.General clinical data were collected,and HGI differences between groups were analyzed.Results Patients with NPDR and PDR group had significantly higher HGI than those with NC.PDR patients had higher HGI than NPDR patients.Similarly,NCI-DME and CI-DME patients had significantly higher HGI than NDME patients,with CI-DME having the highest HGI.Univariate Logistic regression analysis revealed significant correlations between the presence of DR and T2DM,course of diabetes(P<0.01),body mass index(P=0.01),diastolic blood pressure(P=0.04),HGI(P=0.01),fasting plasma glucose(P=0.04),and HbA1c(P=0.01).Additionally,a significant correlation(P<0.001)was found between HGI and DR severity.Conclusion HGI is closely associated with the severity of both DR And DME in T2DM patients.