2型糖尿病患者并发糖尿病视网膜并发症多重危险因素分析

The study of risk factors related to diabetic retinopathy in Type 2 Diabetes mellitus

研究背景和目的糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病(DM)患者最常见,最严重的微血管并发症之一,除遗传因素外,环境因素在DR的发生发展中起着非常重要的作用。本研究旨在探讨2型糖尿病患者易于发生视网膜并发症的多重危险因素。材料与方法随机选择无亲缘关系的T2DM患者274例和120例健康个体,均为汉族人。分为正常对照组、单纯糖尿病组、糖尿病视网膜病变组三个病例组,搜集相应的临床资料并检测有关临床与生化指标,对不同组间的临床与生化指标进行统计分析,并对糖尿病患者易发视网膜病变的危险因素进行logistic回归分析。结果糖尿病视网膜病变组糖化血红蛋白水平、血脂水平,血管内皮生长因子(VEGF)水平以及合并肾脏病变的比率显著高于单纯糖尿病组,而C肽水平显著低于单纯糖尿病组,多重回归显示血管内皮生长因子(VEGF)水平,LDL、TC、HbA1c水平,合并肾脏病变与糖尿病视网膜病变发生呈正相关。结论 VEGF、LDL、TC、TG、HbA1c、合并肾脏病变可能是2型糖尿病易发视网膜病变的独立危险因素。

Objective： To investigate the probalble risk factors related to the devolepment of diabetic retinopathy. Methods： All subjects randomly recruited in this study were divided into DR group （diabetic retinopathy group）, NDR group （type 2 diabetes without retinopathy group） and normal control group. Clinical characteristics were collected and biochemical indexes were measured of all the subjects. All calculations were performed using the SPSS 10.0 version for Windows. Result ： The levels of HbAI c, TC, LDL-C, TG, VEGF were significantly increased in the DR group compared with those in the NDR group and the NC group, the ratio of accompanying the diabetic nephropathy was significantly higher in the DR group than in the NDR group. Multiple logistic analysis showed that the level of HbA1 c, TC, LDL-C and VEGF and the ratio of diabetic nephropathy had positively correlated with the increased risk of DR. Conclusion： The level of HbA1c, TC, LDL-C and VEGF and accompanying diabetic nephropathy may be independent risk factors for type 2 diabetic retinopathy.