老年2型糖尿病患者空腹C肽与视网膜病变关系及相关因素分析

Correlation between fasting C-peptide and retinopathy in elderly patients with type 2 diabetes mellitus and its influencing factors

目的探讨老年2型糖尿病患者空腹血清C肽水平与视网膜病变的相关性,并分析相关的危险因素。方法回顾性选取2018年11月至2019年11月收治的老年2型糖尿病患者共313例,均眼底镜视网膜病变筛查,根据结果分为观察组(视网膜病变)111例和对照组(无视网膜病变)178例。检验2组间的空腹C肽、尿A/C比值(UACR)、收缩压(SBP)、胱抑素C(CysC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、体重指数(BMI)、糖化血红蛋白(HBA1C)、尿酸(UA)及病程有无差别,并对相关因素进行二分类Logistic回归分析。结果与对照组比较,观察组空腹C肽水平低而UACR、病程高,其他相关参数差异无统计学意义(P>0.05)。Logistic回归验证了眼底视网膜病变与空腹C肽相关性,进一步通过(ROC)曲线分析提示空腹C肽、UACR、病程的联合检测对眼底视网膜病变有较好的预测价值。结论低空腹C肽水平对糖尿病合并眼底视网膜病变有积极的预测价值,联合病程、UACR预测价值更高。

Objective To investigate the correlation between fasting serum C-peptide level and retinopathy in elderly patients with type 2 diabetes mellitus(T2DM),and to analyze the risk factors.Methods A total of 313 elderly patients with T2DM admitted from NovembeR2018 to NovembeR2019 were retrospectively selected.All of them were screened foRretinopathy undeRophthalmoscope.According to the results,those patients with retinopathy were divided into the observation group(n=111)and those without retinopathy were included in the control group(n=178).Fasting C-peptide,urinary albumin to creatine ratio(UACR),systolic blood pressure(SBP),cystatin C(CysC),low density lipoprotein cholesterol(LDL-C),triglycerides(TG),body mass index(BMI),glycosylated hemoglobin(HBA1C),uric acid(UA),and course of disease were compared between groups.Risk factors foRretinopathy in elderly patients with T2DM were identified by binary logistic regression analysis.Results Compared with those of control group,patients in the observation group presented the significantly loweRfasting C-peptide,higheRUACRlevel and longeRcourse of disease.There were no significant differences in otheRclinical data between groups(P>0.05).Logistic regression verified the correlation between fundus retinopathy and fasting C-peptide in elderly patients with T2DM.ReceiveRoperating characteristic(ROC)curves revealed that a combination detection of fasting C-peptide,UACRand course of disease had a good predictive value foRfundus retinopathy in elderly patients with T2DM.Conclusion Low fasting C-peptide level has a positive predictive value foRdiabetic retinopathy in elderly patients with T2DM,which is much higheRin the combination detection of UACRlevel and course of disease.