2型糖尿病合并视网膜病变老年患者血清脂联素及同型半胱氨酸的水平分析

Analysis on levels of serum adiponectin and homocysteine in elderly patients with type 2 diabetes complicating retinopathy

目的探讨2型糖尿病合并视网膜病变老年患者的血清脂联素(APN)和同型半胱氨酸(Hcy)水平及其相关性。方法从该院2012年1月至2014年12月住院治疗的2型糖尿病患者中筛选68例合并视网膜病变老年患者(T2DM+DR组),调查其一般资料,检测常规生化指标并采用酶联免疫吸附法测定血清总APN、高分子量APN及Hcy水平,同时采用Pearson相关分析法评价三者间的相关性。选取同期65例老年2型糖尿病患者(T2DM组)和70例老年健康体检者(NC组)作对照。结果T2DM、T2DM+DR组的腰臀比、空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、糖化血红蛋白、空腹血胰岛素及胰岛素抵抗指数水平均高于NC组,高密度脂蛋白胆固醇水平低于NC组;T2DM+DR组的病程和体质量指数均高于T2DM组,差异均有统计学意义(P<0.05);T2DM、T2DM+DR组的总APN和高分子量APN水平均低于NC组,总APN与高分子量APN的比值(H/T)亦低于NC组(P<0.05),但Hcy水平高于NC组(P<0.05);且T2DM+DR组的总APN、高分子量APN水平均低于T2DM组,Hcy水平高于T2DM组,差异均有统计学意义(P<0.05);T2DM+DR组血清总APN(r=-0.654)、高分子量APN(r=-0.562)水平均与Hcy水平呈负相关(P<0.05)。结论 2型糖尿病合并视网膜病变老年患者的血清APN水平降低、Hcy水平升高,可能与2型糖尿病的视网膜病变进展有关。

Objective To explore the levels of serum adiponectin（APN）and homocysteine（Hcy）in elderly patients with type2 diabetes mellitus（T2DM）complicating retinopathy and the relation between these two indicators.Methods Sixt-eight cases of complicating retinopathy（T2DM＋DR group）were screened from the elderly inpatients with T2 DM in our hospital from January2012 to December 2014.Their general data were investigated.The routine biochemical indicators were tested.The enzyme-linked immunosorbent assay（ELISA）was employed to measure the serum total APN,high molecular weight APN and Hcy levels.Meanwhile the correlation among total APN,high molecular weight APN and Hcy was evaluated by adopting the Pearson correlation analysis.Contemporaneous 65 cases of elderly T2 DM and 70 elderly people undergoing the healthy physical examination were chosen as the T2 DM group and NC group respectively.Results The WHR,FBP,TC,TG,LDL-C,HbA1 c,FINS and HOMA-IR in the T2DM＋DR group and T2 DM group were higher than those in the NC group,while the HDL-C level was lower than that in the NC group（P〈0.05）;the duration and BMI of the T2DM＋DR group were higher than those of the T2 DM group,the difference was statistically significant（P〈0.05）;the levels of total APN and high molecular weight APN in the T2DM＋DR group and T2 DM group were lower than those in the NC group,while the Hcy level was higher than that in the NC group（P〈0.05）;moreover the levels of total APN and high molecular weight APN in the T2DM＋DR group were lower than those in the T2 DM group,and Hcy level was higher than that in the T2 DM group,the difference was statistically significant（P〈0.05）;the levels of total APN（r=-0.654）and high molecular weight APN（r=-0.562）were negatively correlated with the Hcy level in the T2DM＋DR group（P〈0.05）.Conclusion The serum APN level is decreased and Hcy level is increased in elderly patients with T2 DM complicating retinopathy,which may be associated with the progression of retinopathy in T2 DM.