ABI、TBI指数、血清Cys C与T2DM合并视网膜病变关系

The relationship between ABI,TBI index,serum Cys C and T2DM with retinopathy

目的探讨踝肱指数(ABI)、趾肱指数(TBI)与血清胱抑素C(Cys C)对2型糖尿病(T2DM)患者并发视网膜病变的相关性及临床意义。方法选取2017年9月-2019年12月岳池县人民医院T2DM合并视网膜病变患者106例为研究组,同期单纯T2DM患者106例为对照组。测定比较两组ABI、TBI、血清Cys C及糖脂代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、总胆固醇(TC)、甘油三脂(TG)]水平,分析T2DM合并视网膜病变的影响因素,统计不同ABI、TBI、血清Cys C水平患者糖脂代谢指标水平,探讨各指标与患者糖脂代谢指标的相关性。结果研究组ABI、TBI水平低于对照组,血清Cys C水平高于对照组,差异有统计学意义(t=10.001、5.677、12.650,P<0.05)。ABI、TBI、血清Cys C为T2DM合并视网膜病变的影响因素(OR=0.452、0.440、4.926,P<0.05)。研究组FPG、2 hPG、TC、TG水平高于对照组,差异有统计学意义(t=26.263、18.481、11.249、18.446,P<0.05)。ABI、TBI与T2DM合并视网膜病变患者FPG、2 hPG、TC、TG水平呈负相关(r=-0.705、-0.786、-0.589、-0.817;-0.734、-0.768、-0.742、-0.598;P<0.05),Cys C与T2DM合并视网膜病变患者FPG、2 h PG、TC、TG水平呈正相关(r=0.692、0.671、0.701、0.572,P<0.05)。结论ABI、TBI、血清Cys C是T2DM合并视网膜病变的重要影响因素,并与糖脂代谢紊乱存在一定关联性,可为临床诊治、评估病情程度提供循证依据。

Objective To investigate the value and clinical significance of ankle-brachial index(ABI),toe-brachial index(TBI)and serum cystatin C(Cys C)on the incidence of retinopathy in patients with type 2 diabetes mellitus(T2 DM).Methods From September 2017 to December 2019,106 patients with T2 DM and retinopathy in our hospital were selected as the research group,and 106 patients with T2 DM alone during the same period as the control group. The levels of ABI,TBI,serum Cys C and glucose and lipid metabolism indexes[fasting plasma glucose(FPG),2 h postprandial plasma glucose(2 hPG),total cholesterol(TC)and triglyceride(TG)]in the two groups were compared. The influencing factors of T2 DM combined with retinopathy were analyzed. The levels of glucose and lipid metabolism in patients with different ABI,TBI,and serum Cys C levels were measured. The correlations between each index and the patient’s index of glucose and lipid metabolism were analyzed. Results The ABI and TBI levels of the research group were lower than those of the control group,and the serum Cys C level was higher than that of the control group(t=10.001,5.677,12.650,P<0.05).ABI,TBI and serum Cys C were the important influencing factors of T2 DM complicated with retinopathy(OR=0.452,0.440,4.926,P<0.05). The levels of FPG,2 h PG,TC and TG in the research group were higher than those in the control group(t=26.263,18.481,11.249,18.446,P<0.05). FPG,2 hPG,TC and TG levels in patients with ABI(r=-0.705,-0.786,-0.589,-0.817),TBI(r=-0.734,-0.768,-0.742,-0.598)were negatively correlated with the levels of FPG,2 hPG,TC,and TG in patients with T2 DM and retinopathy. Cys C(r=0.692,0.671,0.701,0.572)was positively correlated with FPG,2 hPG,TC,and TG levels in patients with T2 DM and retinopathy(P<0.05). Conclusion ABI,TBI and serum Cys C were important influencing factors of T2 DM combined with retinopathy,and had a certain correlation with glucose and lipid metabolism disorders,which could provide evidence for clinical diagnosis and treatment and assessment of the degree of the disease.