Lp-PLA2活性与糖尿病性视网膜病变的风险和预后的相关性

Correlation of Lp-PLA2 activity with risk and prognosis of diabetic retinopathy

目的探析脂蛋白相关磷脂酶A2(lipoprorein-assoeiated phosphohpase A2,Lp-PLA2)活性与糖尿病性视网膜病变(diabetic retinopathy,DR)的风险和预后的相关性。方法研究选取2017年2月~2019年2月我院收治的糖尿病患者80例,其中包括单纯2型糖尿病患者40例,设为糖尿病组;并发DR患者40例,设为视网膜病变组。另选取同期体检健康、年龄相匹配的志愿者30例,设为对照组。采集3组空腹静脉血,常规检测空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、C反应蛋白(CRP)和血清Lp-PLA2浓度,进行比较分析。结果三组平均年龄、体质指数差异无明显统计学意义(P>0.05);视网膜病变组患者体质指数(25.00±0.84kg/m^(2))、平均病程(5.02±3.45年)略高于糖尿病组(BMI=24.82±0.92kg/m^(2),平均病程4.86±2.72年),但组间差异无统计学意义(t=2.34,P>0.05)。对照组志愿者FBG、TC、TG、CRP及Lp-PLA2水平均低于其他两组,LDL、HDL水平高于其他两组,差异均有统计学意义(F=8.44,39.43,8.84,86.70,13.95,P均<0.05);糖尿病组与视网膜病变组患者FBG、TC、TG、LDL、HDL、CRP指标差异不显著(P>0.05),但视网膜病变组Lp-PLA2水平(89.65±7.36 pg/μL)明显高于糖尿病组(64.29±9.48pg/μL),差异有统计学意义(F=204.90,P<0.05)。血清Lp-PLA2活性与DR的发病具有一定相关性(OR=2.343,P<0.05)。结论血清Lp-PLA2水平上调可提示2型糖尿病患者具有并发DR风险,检测该指标变化对患者DR风险预防有重要意义。

Objective To Investigate the correlation between lipoprorein-assoeiated phosphohpase A2(lp-pla2)activity and the risk and prognosis of diabetic retinopathy(DR).Methods From February 2017 to February 2019,80 diabetic patients,including 40 patients with type 2 diabetes only,were selected as the diabetes group.Forty patients complicated with DR were assigned to the retinopathy group.Meanwhile,30 healthy and age-matched volunteers were selected as the control group.Fasting venous blood was collected from the three groups.Fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TC),low-density lipoprotein(LDL),high-density lipoprotein(HDL),c-reactive protein(CRP)and serum lp-pla2 concentrations were routinely detected for comparative analysis.Results There was no significant difference in mean age and body mass index among the three groups(P>0.05).The body mass index and mean course of disease in the retinopathy group were slightly higher than those in the diabetes group,but the difference between the groups was not statistically significant(P>0.05).The levels of FBG,TC,TG,CRP and lp-pla2 in the control group were lower than those in the other two groups,and the levels of LDL and HDL were higher than those in the other two groups,with statistically significant differences(P<0.05).FBG,TC,TG,LDL,HDL and CRP indexes in the diabetic group and the retinopathy group were not significantly different(P>0.05),but the level of lp-pla2 in the retinopathy group(89.65±7.36 pg/μL)was significantly higher than that in the diabetic group(64.29±9.48 pg/μL),and the difference was statistically significant(P<0.05).Serum lp-pla2 activity is correlated with the occurrence of DR(P<0.05).Conclusion Elevation of serum lp-pla2 level may indicate the risk of concurrent DR in patients with type 2 diabetes,and the detection of indicator changes is great significance for evaluating patient treatment and early prevention of DR.