血清C肽及胰岛素抵抗在糖尿病视网膜病变中的应用价值

Application Value of Serum C-peptide and Insulin Resistance in Diabetic Retinopathy

目的:分析血清C肽与胰岛素抵抗水平对2型糖尿病患者糖尿病视网膜病变(diabetic retinopathy,DR)的预测价值。方法:选取2019年6月-2020年6月就诊于辽宁省健康产业集团抚矿总医院内分泌科的266例2型糖尿病患者。根据是否合并DR分为DR组(n=168)与单纯糖尿病组(DM组,n=98)。比较两组一般资料及实验室指标,分析DR的影响因素及各影响因素对DR的预测价值。结果:DR组病程、BMI、空腹胰岛素(FINS)、糖化血红蛋白(HbA1c)及胰岛素抵抗指数(HOMA-IR)均高于DM组,且空腹C肽(FCP)低于DM组(P<0.05)。病程、BMI、HbA1c、FINS及HOMA-IR是DR的危险因素,FCP是DR的保护因素(P<0.05)。ROC曲线显示FCP与HOMA-IR的AUC分别为0.779与0.721,均高于其他指标。结论:病程、BMI、HbA1c、FINS及HOMA-IR是DR的危险因素,FCP是DR的保护因素,其中FCP与HOMA-IR对DR具有较高的预测价值。

Objective:To analyze the predictive value of serum C-peptide and insulin resistance in diabetic retinopathy(DR)in patients with type 2 diabetes.Method:A total of 266 patients with type 2 diabetes who were admitted to the department of endocrinology of Fukuang General Hospital of Liaoning Health Industry Group from June 2019 to June 2020 were selected.The patients were divided into DR group(n=168)and DM group(n=98)according to whether they were complicated with DR.The general data and laboratory indicators of the two groups were compared to analyze the influencing factors of DR and the predictive value of each influencing factor on DR.Result:The duration,BMI,fasting insulin(FINS),hemoglobin A1c(HbA1c)and insulin resistance index(HOMAIR)in the DR group were higher than those in the DM group,and fasting C-peptide(FCP)was lower than that in the DM group(P<0.05).Duration,BMI,HbA1c,FINS and HOMA-IR were risk factors for DR,and FCP was a protective factor for DR(P<0.05).ROC curve showed that the AUC of FCP and HOMA-IR were 0.779 and 0.721,respectively,which were higher than other indexes.Conclusion:Duration,BMI,HbA1c,FINS and HOMA-IR are risk factors for DR,FCP is protective factor for DR,and FCP and HOMA-IR have higher predictive value for DR.