2型糖尿病患者血清胆红素水平与视网膜病变的关系

Relationship between serum bilirubin levels and retinopathy in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)视网膜病变与血清胆红素水平之间的关系。方法选择2017年4月至2018年4月安徽省立医院收治的T2DM患者203例,根据眼底检查结果分为糖尿病视网膜病变(DR)组(78例)与非糖尿病视网膜病变(NDR)组(125例),比较两组患者之间血清胆红素水平的差异,并对DR的影响因素进行logistic回归分析。结果 DR组患者的总胆红素、直接胆红素和间接胆红素水平分别为(9. 91±3. 55)、(3. 35±1. 25)和(6. 55±2. 72)μmol/L,均低于NDR组,而病程、糖化血红蛋白、总胆固醇和低密度脂蛋白胆固醇分别为(10. 77±4. 85)年、(9. 19±1. 78)%、(4. 25±0. 72)和(2. 61±0. 66) mmol/L,均高于NDR组,差异有统计学意义(P <0. 05)。logistic回归分析显示,总胆红素是DR的保护性因素(P <0. 05),而病程、低密度脂蛋白胆固醇是DR的独立危险因素(P <0. 05)。结论胆红素可能在DR的发生发展中起到保护性作用,应重视胆红素的抗氧化作用。

Objective To investigate the association between serum bilirubin levels and diabetic retinopathy in patients with type 2diabetes mellitus( T2DM). Methods Aretrospective analysis was performed on 203 cases of T2DM in Anhui Provincial Hospital from April2017 to April 2018. All cases were divided into diabetic retinopathy( DR) group( 78 cases) and non-diabetic retinopathy( NDR) group( 125cases) based on the results of fundus examination. The level of serum bilirubin between the two groups was compared and the significant parameters were taken to the logistic regression formula. Results The total bilirubin,direct bilirubin and indirect bilirubin levels in DR group were( 9. 91 ± 3. 55),( 3. 35 ± 1. 25) and( 6. 55 ± 2. 72) μmol/L respectively,which were lower than those in NDR group( P < 0. 05). The duration,hemoglobin A1c( HbA1c),total cholesterol( TC) and low density lipoprotein-cholesterol( LDL-C) in DR group was( 10. 77 ±4. 85) year,( 9. 19 ± 1. 78) %,( 4. 25 ± 0. 72) and( 2. 61 ± 0. 66) mmol/L respectively,which were higher than those in NDR group( P <0. 05). Logistic regression analysis showed that serum total bilirubin was a protective factor of DR( P < 0. 05),while the duration and LDL-C levelwere risk factors of DR( P < 0. 05). Conclusion Bilirubin may play a protective role in the onset and development of DR. The bilirubin antioxidant effect should be taken seriously.