血清鸢尾素、FGF-21、TNF-α、IL-6联合检测对2型糖尿病患者发生视网膜病变的预测价值

The predictive value of combined detection of serum irisin,FGF-21,TNF-αand IL-6 for retinopathy in patients with type 2 diabetes mellitus

目的探讨血清鸢尾素、成纤维细胞生长因子-21(FGF-21)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)联合检测对2型糖尿病患者发生视网膜病变的预测价值。方法选取2019年10月至2022年10月在该院就诊的98例2型糖尿病患者作为研究对象,根据患者有无糖尿病视网膜病变分为病变组(n=30)和无病变组(n=68)。比较两组临床资料;采用受试者工作特征(ROC)曲线分析血清鸢尾素、FGF-21、TNF-α、IL-6单独及联合检测对2型糖尿病患者发生视网膜病变的预测价值;采用多因素Logistic回归性分析2型糖尿病患者发生视网膜病变的危险因素。结果病变组鸢尾素水平明显低于无病变组,FGF-21、TNF-α、IL-6水平均明显高于无病变组,差异均有统计学意义(P<0.05);ROC曲线分析结果显示,血清鸢尾素、FGF-21、TNF-α、IL-6预测2型糖尿病患者发生视网膜病变的曲线下面积分别为0.782、0.748、0.825、0.808,灵敏度分别为0.600、0.733、0.800、0.667,特异度分别为0.897、0.632、0.838、0.794,血清鸢尾素、FGF-21、TNF-α、IL-6联合检测预测2型糖尿病患者发生视网膜病变的曲线下面积为0.948,灵敏度为0.833,特异度为0.618;多因素Logistic回归分析结果显示,鸢尾素水平降低及FGF-21、TNF-α、IL-6水平升高是2型糖尿病患者发生视网膜病变的危险因素(P<0.05)。结论血清鸢尾素、FGF-21、TNF-α、IL-6联合检测用于2型糖尿病患者发生视网膜病变具有较高的预测价值。

Objective To investigate the predictive value of combined detection of serum irisin,fibroblast growth factor-21(FGF-21),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)for retinopathy in patients with type 2 diabetes mellitus.Methods A total of 98 patients with type 2 diabetes mellitus who were treated in the hospital from October 2019 to October 2022 were selected as the research objects.According to the presence or absence of diabetic retinopathy,they were divided into pathological group(n=30)and non-pathological group(n=68).The clinical data of the 2 groups were compared.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum irisin,FGF-21,TNF-α,IL-6 alone and combined detection for retinopathy in patients with type 2 diabetes mellitus.Multivariate Logistic regression was used to analyze the risk factors of retinopathy in patients with type 2 diabetes.Results The levels of irisin in pathological group were significantly lower than those in non-pathological group,and the levels of FGF-21,TNF-αand IL-6 were significantly higher than those in non-pathological group,with statistical significance(P<0.05).ROC curve analysis showed that the area under the curve of serum irisin,FGF-21,TNF-αand IL-6 for predicting retinopathy in patients with type 2 diabetes mellitus was 0.782,0.748,0.825 and 0.808 respectively,and the sensitivity was 0.600,0.733,0.800 and 0.667 respectively.The specificity was 0.897,0.632,0.838 and 0.794 respectively.The area under the curve of combined detection of serum irisin,FGF-21,TNF-αand IL-6 for predicting retinopathy in patients with type 2 diabetes was 0.948,the sensitivity was 0.833 and the specificity was 0.618.Multivariate Logistic regression analysis showed that decreased levels of irisin and increased levels of FGF-21,TNF-αand IL-6 were risk factors for retinopathy in patients with type 2 diabetes mellitus(P<0.05).Conclusion The combined detection of serum irisin,FGF-21,TNF-αand IL-6 has a high predictive value for retinopathy in type 2 diabetes mellitus.