血清胆红素和脂质过氧化物水平与2型糖尿病视网膜病变的相关性研究

THE RELATION OF BILIRUBIN AND MALONDIALDEHYDE WITH DIABETIC RETINOPATHY IN 2 DIABETES MELLITUS

目的:测定2型糖尿病伴或不伴糖尿病视网膜病变(diabetic retinopathy,DR)的病人血清中胆红素和脂质过氧化物(malondialdehyde,MDA)水平,探讨其与糖尿病视网膜病变严重程度的相关性。方法:研究共纳入160人。无糖尿病病人60人作为对照。其余患有2型糖尿病的病人100人作为实验组,其中有54名病人无DR,46名病人伴有DR。结果:对照组血清中总胆红素、直接胆红素、间接胆红素水平均高于实验组(P=0.016,0.032,0.023)。同时,糖尿病病人血清MDA水平高于对照组(P=0.00)。血清总胆红素、直接胆红素、间接胆红素水平较不伴DR病人血清水平低(P=0.00,0.019和0.006)。受试者基于血清总胆红素浓度,DR与胆红素的相关性在最高四分位数的胆红素病人中相比于最低四分位数组显著降低。DR的严重程度与总胆红素水平成反比(P=0.001)。多元回归分析表明总胆红素水平与DR相关(P=0.034)。结论:糖尿病伴有DR的血清总胆红素水平较不伴有DR的糖尿病病人和对照组显著降低,而MDA水平没有显示出与DR有任何关联性。

Objective：To measure the levels of serum bilirubin and MDA in type 2 DM patients with and without diabetic retinopathy（ DR） and to correlate them with severity of DR. Methods：A total number of 160 patients,60 were controls without type 2 DM and the rest 100 were type 2 DM patients were recruited in the study. The 100 diabetics, out of which 54 patients did not have DR and 46 patients had DR. Results：The three parameters,total bilirubin,direct bilirubin,indirect bilirubin were higher in controls as compared to experiment group （ P=0 . 016 , 0 . 032 , 0 . 023 ） . Serum MDA levels were shown to be higher in diabetics when compared to controls（P=0. 00）. The values of all the three parameters,total bilirubin,direct bilirubin and indirect bilirubin were lower in patients with retinopathy as compared to those without retinopathy（P=0. 00,0. 019,and 0. 006）. Data were assigned to quartiles based on serum total bilirubin concentration. Among patients with the highest bilirubin quartile, the prevalence of DR was significantly lower compared to those with the lowest one. The total bilirubin levels was inversely proportional to the severity of DR （ P=0 . 001 ） . In multiple logistic regression analysis it was showed that total bilirubin to be related to prevalence of DR（P=0. 034）. Conclusions：In patients with DR,the levels of total bilirubin were significantly lower and also in the late stages of retinopathy as compared to those without retinopathic changes and in controls but MDA levels was not relavent to DR.