2型糖尿病视网膜病变患者血清RBP4水平变化及其与胰岛素抵抗的关系研究

To study the level of serum RBP4 in type 2 diabetic retinopathy patients,and the correlation with insulin-resistance

目的:本研究通过观察2型糖尿病视网膜病变患者血清RBP 4的水平变化,探讨其变化规律及其与IR的相关关系。方法:选取2型糖尿病视网膜病变患者(DR)37例,新诊断2型糖尿病无视网膜病变者(NDR)30例,正常体检者(NC)30例设为对照。观察各组空腹血清视黄醇结合蛋白4(RBP 4)水平并计算其胰岛素抵抗指数(HOMA-IR)。结果:①DR组血清RBP 4水平显著高于NDR组(P<0.05),NDR组血清RBP 4水平显著高于NC组(P<0.05)。②单因素相关分析显示,血清RBP 4与体重指数(BM I)、空腹血糖(FPG)、HOMA-IR呈正相关,与门冬氨酸氨基转移酶(A ST)、丙氨酸氨基转移酶(ALT)、胰岛β功能指数(HOMA-β)呈负相关。③多元逐步回归分析发现HOMA-β与BM I为影响血清RBP 4最显著因素,常数项为零。结论:2型糖尿病视网膜病变患者血清RBP 4水平较新诊断2型糖尿病患者及正常者显著升高;血清RBP 4水平升高除通过IR参与T 2DM的发生外,还可能在DR的发生、发展中起重要作用。

Objective：In this study,by observing the type 2 diabetic retinopathy,type 2 diabetes patients without retinopathy and normal physical changes in serum RBP4 levels,variation and explore its relationship with the IR.Method：Fundus photography fundus screening hospital patients and medical endocrinology normal population,145 cases were selected normal glucose regulation.（NC） 30 cases of type 2 diabetes without retinopathy,（NDR） 78 cases of type 2 diabetic retinopathy,（DR） 37 cases.Observe the serum retinol binding protein 4（RBP4） levels change in each group,and determine its clinical general information,record the age,height,weight,etc.and calculate the insulin resistance index（HOMA-IR）.Results：①DR serum RBP4 level was significantly higher than the NDR group（P0.05）.NDR group,serum RBP4 levels were significantly higher than the NC group（P0.05）.② Univariate correlation analysis showed that serum RBP4 was positively correlated with BMI,FPG,HOMA-IR.AST and was negatively correlated with ALT,HOMA-β.③ Multiple regression analysis shows： HOMA-β and BMI are the most significant factors to influence serum RBP4,the constant term is zero.Conclusion：The level of serum RBP4 in Type 2 patients with diabetic retinopathy increased significantly more than in the new diagnosed type 2 patients with diabetic retinopathy and normal people;Serum RBP4 levels may be associated with high expression of the β-cell function,RBP4 levels might be involved in the IR and the occurrence and development of DR.