血清TG/HDL及瘦素脂联素水平与2型糖尿病视网膜病变的相关性

Correlation analysis of serum levels of TG/HDL,leptin and adiponectin with type 2 diabetic retinopathy

目的探讨血清TG/HDL、瘦素、脂联素水平与2型糖尿病视网膜病变(Diabetic retinopathy,DR)的相关性。方法纳入2015年1月～2016年12月苏州大学第二附属医院高新区医院住院的2型糖尿病患者194例为研究对象,按照2003年DR的国际临床分期标准及病情严重程度依次将其分为非糖尿病视网膜病变组(NDR)32例、轻度非增殖型糖尿病视网膜病变组(NPDR)30例、中度非增殖型糖尿病视网膜病变组(NPDR)38例、重度非增殖型糖尿病视网膜病变组(NPDR)32例、增殖期糖尿病视网膜病变组(PDR)28例及高危糖尿病视网膜病变组(PDR)24例,并选择同期健康体检人群40例作为健康对照组(NC),测量各组血生化指标、计算TG/HDL-C,测量HbA1c、血清瘦素和脂联素水平,分析TG/HDL、瘦素、脂联素与DR病变关系。结果各组TC和LDL-C比较差异无统计学意义(P>0.05),HDLC及TG/HDL-C比较差异有统计学意义(P<0.05);各组血清瘦素、血清脂联素水平差异有统计学意义(P<0.05);多元logistic回归分析结果显示HDL-C与DR严重程度无相关性(P>0.05);TG/HDL-C、血清瘦素与DR严重程度呈正相关(P<0.05);血清脂联素与DR严重程度呈负相关(P<0.05)。结论血清TG/HDL、瘦素水平可能是2型糖尿病视网膜病变的独立危险因素,脂联素是2型糖尿病视网膜病变的保护因素,三者均可在一定程度上对糖尿病视网膜病变的预测及疗效评估提供临床依据。

Objective To investigate the association of serum TG/HDL,leptin and adiponectin levels with type 2 diabetic retinopathy（Diabetic,retinopathy,DR）.Methods From January 2015 to December 2016 in our hospital,194 diabetic patients with T2 were divided into abnormal non diabetic retinopathy（NDR）,mild non proliferative diabetic retinopathy group（NPDR）,moderate non proliferative diabetic retinopathy group（NPDR）and severe non proliferative diabetic retinopathy group（NPDR）,proliferative diabetic retinopathy group（PDR）,and the high risk of diabetic retinopathy（PDR）according to the 2003 DR international clinical staging standard and severity degree.40 healthy people were selected as healthy control group（NC）.The blood biochemical parameters,calculation of TG/HDL-C measurement,HbA1 C,serum leptin and adiponectin levels of TG/HDL,leptin and adiponectin and DR lesions were measured.Results There there was no significant difference between groups TC and LDL-C（P〉0.05）.HDL-C and TG/HDL-C were statistically significant difference（P〈0.05）.Each group had a significant difference between serum leptin and serum adiponectin levels（P〈0.05）.Multivariate logistic regression analysis showed that SBP and HDL-C had no correlation with the severity of DR（P〉0.05）,TG/HDL-C,serum leptin and the severity of DR was positive（B=1.838,B=0.195,P〈0.05）.The serum adiponectin and the severity of DR（B=-0.609,P〈0.05）were negative correlation.Conclusion TG/HDL and serum leptin levels were independent risk factors of retinopathy in patients with type 2 diabetes.Adiponectin is a protective factor of type 2 diabetic retinopathy.TG/HDL,serum leptin and Adiponectin may have the prediction,evaluation and treatment of diabetic retinopathy and provide clinical evidence.