不同糖耐量人群游离脂肪酸与糖尿病视网膜病变的关系

Relationship of free fat acid and diabetic retinopathy in people with different glucose tolerance

目的探讨在不同糖耐量人群中游离脂肪酸(FFA)与糖尿病视网膜病变的关系。方法根据口服葡萄糖耐量试验(OGTT)结果将研究对象分为正常糖耐量组(NC)、葡萄糖调节异常组(IGR)、糖尿病(DM)组,测定空腹血清游离脂肪酸、血脂谱等,同时通过眼底镜检查和/或眼底荧光血管造影检查了解糖尿病视网膜病变(DR)。结果(1)IGR合并视网膜病变组(IGR+)FFA水平显著高于NC组。DR组FFA水平显著高于NC组、IGR组、DM组。DR组收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)大于IGR组,而与IGR+组比较差异无统计学意义。(2)IGR+组FFA与年龄、SBP、DBP呈正相关,DM组FFA与TG呈正相关。(3)多元回归分析显示,FBG、舒张压是DR组FFA增加的独立危险因素。结论空腹血清游离脂肪酸与糖尿病视网膜病变显著相关,动态检测血清游离脂肪酸水平可作为临床监测DR的客观指标。

Objective To search the relationship of free lipid acid（FFA） and diabetic retinopathy（DR） in people with different glucose tolerance. Methods 60 patients with diabetes mellitus（DM） ,51 people with impaired glucose regulation（IGT） and 21 normal controls（NC） were measured the fasting FFA and lipid profile by the biochemistry methods. And the differentiation of DR was based on the eye-ground microscopy and/or fluorescent blood vessel photogram in eye-ground. Results People with IGR and DR had higher FFA level than NC. The FFA level in patient with DM and DR was higher than that in one with IGR,DM or NC. Patient with DM and DR had higher systolic blood pressure（SBP）,diastolic blood pressure（DBP） and triglyceride（TG） than people with IGR,and the same as people with IGR and DR. The fasting FFA level was positively related with age,SBP and DBP in people with IGR and DR,and was positively related with TG in people with DM. The multiple parameter regression showed that the fasting blood glucose and DBP were the independent factors in patients with DM and DR. Conclusion Fasting serum FFA is evidently associated to diabetic retinopatby,the measurement of serum FFA may act as an index of clinical diabetic retinopathy.