血清内脏脂肪素和肿瘤坏死因子α与老年2型糖尿病患者白内障的关系

Relationships between serum levels of visfatin and tumor necrosis factor-α and cataract in elderly patientswith type 2 diabetes mellitus

目的观察和分析血清内脏脂肪素(visfatin)和肿瘤坏死因子α(TNF-α)与老年2型糖尿病(T2DM)患者白内障的关系。方法选取154例老年T2DM合并白内障患者,根据其白内障分期将其分为A组(初发期白内障病例,53例)、B组(未成熟期白内障病例,41例)、C组(成熟期白内障病例,50例)和D组(过熟期白内障病例,10例),选取50例健康志愿者作为对照组,对各组研究对象的空腹血糖(FBG)、糖化血红蛋白(Hb A1c)、胰岛素水平及血清visfatin、TNF-α水平进行检测和比较。结果随着白内障临床分期的升高,T2DM合并白内障患者的FBG、Hb A1c水平及血清visfatin、TNF-α水平逐渐升高,且均高于对照组,而胰岛素水平逐渐降低,且均低于对照组,组间差异均有统计学意义(P<0.05);Spearman等级相关分析结果显示,T2DM合并白内障患者的白内障分期与FBG、Hb Alc、TNF-α、visfatin均呈正相关关系,而与胰岛素呈负相关关系(P<0.05)。结论 T2DM患者的白内障分期与其血清visfatin、TNF-α水平具有相关性,这两种血清因子的过表达可能参与了糖尿病性白内障的进展过程,可作为评价患者病情的辅助指标。

Objective To observe and analyze the relationships between serum levels of visfatin and tumor necrosis factor-α（ TNF-α） and cataract in elderly patients with type 2 diabetes mellitus（ T2DM）. Methods 154 cases of elderly T2 DM patients were selected and divided into group A（ primary cataract,n = 53 cases）,group B（ immature cataract,n = 41 cases）,group C（ mature cataract,n = 50 cases） and group D（ hypermature cataract,n = 10 cases）. 50 healthy volunteers were enrolled as the control group. Fasting blood glucose（ FBG）,glycosylated hemoglobin（ Hb A1c）,insulin levels and serum visfatin,TNF-α levels were measured and compared. Results As the clinical stage advances,FBG,Hb A1 c levels and the serum visfatin,TNF-α levels increased in cataract patients with T2 DM and were higher than those in control group. Insulin level reduced gradually and was lower than that in the control group,and the differences between groups were statistically significant（ P〈0. 05）. Spearman rank correlation analysis showed that the cataract stage of patients with T2 DM was positively correlated with FBG,Hb Alc,visfatin or TNF-α level and was negatively correlated with insulin level（ P〈0. 05）. Conclusions The stage of cataract in patients with T2 DM was correlated with visfatin or TNF-α level. Overexpression of both serum factors may play an important role in the progression of diabetic cataract and can assist in patient evaluation.