2型糖尿病视网膜病变危险因素分析

Analysis of risk factors of type 2 diabetic retinopathy

目的探讨2型糖尿病(T2DM)视网膜病变的危险因素。方法回顾性分析2016年12月至2019年4月在新乡医学院第三附属医院就诊的208例T2DM患者的临床资料,根据无散瞳眼底彩色照相检查结果将患者分为糖尿病视网膜病变(DR)组(n=94)和无DR组(n=114),通过单因素分析T2DM视网膜病变的相关因素,采用logistic回归分析T2DM视网膜病变的危险因素,绘制受试者工作特征曲线(ROC)评估危险因素对DR的预测价值。结果T2DM患者的三酰甘油葡萄糖(TyG)指数、三酰甘油(TG)、血尿酸、病程、收缩压与DR有关(P<0.05),患者的性别、年龄、体质量指数、血肌酐、空腹葡萄糖(FBG)、糖化血红蛋白、舒张压、低密度胆固醇、高密度胆固醇与DR无关(P>0.05)。Logistic回归分析结果显示,TyG指数、血尿酸、病程及收缩压是T2DM视网膜病变的危险因素(P<0.05)。ROC曲线分析结果显示,病程、TyG指数、收缩压、血尿酸预测T2DM发生DR的最佳截断值分别为7.5 a、4.2、138.5 mmHg(1 mmHg=0.133 kPa)、233.2μmol·L-1。病程、TyG指数、收缩压、血尿酸预测T2DM发生DR的曲线下面积分别为0.650、0.637、0.633、0.627,且该4个指标预测T2DM发生DR的曲线下面积比较差异无统计学意义(P>0.05)。结论除血尿酸、病程、收缩压外,TyG指数也与T2DM视网膜病变密切相关,可作为T2DM视网膜病变的预测指标。

Objective To explore the risk factors of type 2 diabetic(T2DM)retinopathy.Methods The clinical data of 208 patients with T2DM in the Third Affiliated Hospital of Xinxiang Medical University from December 2016 to April 2019 were analyzed retrospectively.According to the results of fundus color photography without mydriasis,the patients were divided into diabetic retinopathy(DR)group(n=94)and non-DR group(n=114).Univariate analysis was used to analyze the related factors of T2DM retinopathy;the logistic regression was used to analyze the risk factors of T2DM retinopathy.The value of risk factors in predicting DR was evaluated by drawing subjects′working characteristic curve(ROC).Results The triglyceride glucose(TyG)index,triglyceride(TG)index,serum uric acid,course of disease and systolic blood pressure of patients with T2DM were related to DR(P<0.05).The results of logistic regression showed that TyG index,serum uric acid,course of disease and systolic blood pressure were the risk factors of T2DM retinopathy(P<0.05).The results of ROC curve analysis showed that the best cutoff values of course,TyG index,systolic blood pressure and serum uric acid in predicting the occurrence of DR in patients with T2DM were 7.5 years,4.2,138.5 mmHg(1 mmHg=0.133 kPa)and 233.2μmol·L-1 respectively.The area under ROC of course of disease,TyG index,systolic blood pressure and serum uric acid in predicting the occurrence of DR in patients with T2DM was 0.650,0.637,0.633,0.627 respectively;there was no statistic difference in the area under ROC of course of disease,TyG index,systolic blood pressure and serum uric acid in predicting the occurrence of DR in patients with T2DM.Conclusion In addition to serum uric acid,course of disease and systolic blood pressure,TyG index is also closely related to T2DM retinopathy,and it can be used as a predictive index of T2DM retinopathy.