早期2型糖尿病视网膜病变与血清apoB/apoA1的关系

The relationship between serum apoB/apoA1 ratio and early type 2 diabetic retinopathy

目的:探讨血清载脂蛋白B与载脂蛋白A1比值(apoB/apoA1)与早期糖尿病视网膜病变的相关性及临床意义。方法:收集2013年在河南省人民医院首次住院的90例2型糖尿病患者,依据直接眼底镜检查和眼底荧光血管造影(FFA)将患者分为:糖尿病无视网膜病变组(DM-NDR)(30例)和非增殖型糖尿病视网膜病变组(NPDR)(60例),同时选择30例健康患者。记录患者一般资料、各项血脂指标、收缩压等可能影响糖尿病视网膜病变发生发展的相关指标,并计算apoB/apoA1值。结果:NPDR组的HDL值、apoA1值较DM-NDR组和对照组降低,apoB/apoA1升高,差异有统计学意义(P<0.05);Logistic回归分析显示apoB/apoA1值与糖尿病视网膜病变程度呈正相关(OR=6.302,P=0.000),apoA1值和HDL值与糖尿病视网膜病变程度呈负相关(OR=-2.338和-5.943,P=0.000)。结论:血清apoA1值、HDL值和apoB/apoA1与糖尿病视网膜病变早期发生有关,apoB/apoA1比值增高可作为监测DR进展的一项敏感指标,有助于DR的早诊早治。

Objective： To investigate the relationship between serum apoB/apoA1 ratio with early diabetic retinopathy in type 2 diabetes patients. Methods： 90 patients of first hospitalization were collected from Zhengzhou University People＇ s Hospital, and were divided into three groups accord- ing to the direct ophthalmoscopy and fundus fluorescein angiography （FFA） ： diabetic retinopathy （DM-NDR） group （30 cases） , non proliferative diabetic retinopathy（NPDR） group （60 cases） , and healthy group （30 cases）. Clinical indicators related to the progression of DR, including general information, lipid, systolic blood pressure and apoB/apoA1 were calculated. Results： HDL value and apoA1 value in NPDR group was lower than the DM-NDR group and the control group , apoB/apoA1 increased （P 〈 0.05）. Logistic regression analysis showed that apoB/apoA1 was positively correlated with diabetic retinopathy（ OR = 6. 302,P = 0. 000） , H DL value and apoA1 value was negatively correlated with diabetic retinopathy （ OR = - 2. 338 和 - 5. 943, P = 0. 000）. Conclusion： Serum apoA1, HDL,apoB/apoA1 ratio were related with occurrence of early DR. High apoB/apoA1 can be used as a sensitive index for the early diagnosis and treatment of DR.