老年2型糖尿病病人血红蛋白和糖化血红蛋白水平与视网膜病变风险的相关研究

Relationship between hemoglobin,glycated hemoglobin and retinopathy in the elderly patients with type 2 diabetes mellitus

目的探讨老年T2DM病人Hb、HbA1c水平与视网膜病变风险的关系。方法选取2016年1月至2019年6月于我院接受治疗的92例老年T2DM病人为研究对象,根据眼底检查结果将病人分为2组,42例发生视网膜病变的病人为观察组,50例未发生视网膜病变的病人为对照组。观察并比较2组病人的基线资料,对可能影响T2DM病人发生视网膜病变的因素进行多因素Logistic回归分析。结果观察组的贫血发生率及FPG、HbA1c水平显著高于对照组,Hb水平显著低于对照组,差异均有统计学意义(P<0.05)。单因素分析显示,Hb<130 g/L、贫血、HbA1c≥8.5%是老年T2DM病人发生视网膜病变的影响因素(P<0.01)。多因素Logistic回归分析显示,Hb和HbA1c是老年T2DM病人发生视网膜病变的独立危险因素。结论高水平的Hb可降低视网膜病变的风险,而HbA1c水平越高,病人发生视网膜病变的风险就越高。

Objective To explore the relationship between the levels of hemoglobin(Hb),glycated hemoglobin(HbA1c)and retinopathy in the elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 92 elderly patients with T2DM who were treated in our hospital from April 2016 to April 2019 were enrolled.The patients were divided into two groups,and 42 patients with retinopathy were included in the observed group,50 patients without retinopathy included in the control group.Baseline data were collected and compared between the two groups.Multivariate Logistic regression analysis was performed on risk factors for retinopathy in the patients with T2DM.Results The incidence of anemia and the levels of fasting plasma glucose(FPG)and HbA1c in the observation group were significantly higher,and the level of Hb was significantly lower than that in the control group(P<0.05).Single factor analysis showed that the incidence of retinopathy was related to Hb<130 g/L,anemia and HbA1c≥8.5%(all P<0.01).Multivariate Logistic regression analysis showed that Hb and HbA1c were independent risk factors for retinopathy in the elderly patients with T2DM.Conclusions High level of Hb can significantly reduce the risk of retinopathy,while high level of HbA1c may increase the risk of retinopathy in the elderly patients with T2DM.