2型糖尿病患者糖尿病视网膜病变与C-反应蛋白及代谢综合征关系的研究

The relationships between diabetic retinopathy,C-reactive protein( CRP) and metabolic syndrome

目的观察和分析2型糖尿病患者糖尿病视网膜病变(DR)的发生与C-反应蛋白(CRP)水平和代谢综合征(MS)的关系。方法选取183例2糖尿病患者作为观察对象,根据是否并发有DR将其分为观察组和对照组,101例并发有DR的患者列为观察组,82例未并发DR的患者列为观察组,对两组患者的血清CRP水平、各项常规代谢指标、MS患病率的情况进行观察和比较。结果观察组的血清CRP水平、糖化血红蛋白(HbAlc)水平、甘油三酯(TG)水平、总胆固醇(TC)水平和MS患病率均显著高于对照组(P<0.05),观察组患者脂代谢紊乱的患病率显著高于对照组(P<0.05);各期DR患者的CRP水平和HbAlc水平的差异均有显著性(P<0.05),且随着DR程度的加重,CRP水平和HbAlc水平呈上升的趋势;Logistic多元回归分析显示,患者的TG水平(OR=1.520)和CRP水平(OR=2.376)均与DR的发病呈正相关关系(P<0.05)。结论 HbAlc水平、MS及其中的脂质代谢异常可能是DR发病的危险因素,高CRP水平和高TG水平是DR发病的独立危险因素,且CRP水平、HbAlc水平可能与DR的严重程度具有相关性,临床医生应根据患者的高危因素情况予以早期干预,以改善DR患者的预后。

Objective To observe and analyze the relationship between diabetic retinopathy（ DR）,C-reactive protein（ CRP） and metabolic syndrome（ MS）. Methods Totally 183 patients with type 2 diabetes mellitus were included in this study. Subjects were divided into the two groups according to whether DR presented（ observation group,n = 101）or did not present（ control group,n = 82）. Serum CRP level,routine metabolism indexes,and the prevalence of MS in the two groups were compared. Results Patients in the observation group,i. e.,presented with DR,showed significantly higher levels of serum biomarkers including CRP,HbA1 c,triglyceride and total cholesterol（ P〈 0. 05）. Not surprisingly,the prevalence of MS and dyslipidemia were also higher in the patients with DR（ P〈 0. 05）. Furthermore,CRP and HbA1 c levels were significantly higher in patients with more advanced DR than in patients with milder DR（ P〈 0. 05）.Multivariate logistic regression analysis showed that the triglyceride（ OR = 1. 520） and CRP（ OR = 2. 376） were positively correlated with the incidence of DR（ P〈 0. 05）. Conclusion Increased HbA1 c and presence of MS or dyslipidemia may be the risk factors of DR. The high CRP and high triglyceride levels are independent risk factors of DR. CRP and HbA1 c may be correlated with the severity of DR. Clinicians should employ early interventions among patients with these high risk factors in order to improve the outcomes of DR.