Objectives: The aim of this study was to explore the potential correlation between the GA/HbA1c ratio and diabetic retinopathy (DR) in patients with type 2 diabetes (T2D), as the GA/HbA1c ratio serves as a marker for ...Objectives: The aim of this study was to explore the potential correlation between the GA/HbA1c ratio and diabetic retinopathy (DR) in patients with type 2 diabetes (T2D), as the GA/HbA1c ratio serves as a marker for glycemic variability. Methods: A total of 2565 T2D patients were included in this study and grouped into five categories based on the diagnostic criteria for DR. We examined the impact of the GA/HbA1c ratio on the progression of diabetes. Results: The non-DR group exhibited lower GA/HbA1c levels compared to the DR group. Additionally, as the severity of DR increased among the five groups, there was a corresponding increase in the GA/HbA1c ratio. Logistic regression analysis demonstrated that the GA/HbA1c ratio independently elevated the risk of DR occurrence. Conclusions: The GA/HbA1c ratio can independently predict the occurrence and progression of diabetic retinopathy.展开更多
目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为...目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为研究对象。收集患者的临床资料,包括性别、年龄、血清25(OH)D、空腹胰岛素、C肽、HbA1c、空腹血糖、餐后血糖、尿微量白蛋白、尿白蛋白肌酐比值、血钙、血尿酸(UA)、三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。根据血清25(OH)D水平将患者分为充足组[n=20,25(OH)D≥30μg·L^(-1)]、不足组[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)]、缺乏组[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)]、严重缺乏组[n=113,25(OH)D<10μg·L^(-1)]。比较4组患者各代谢指标的差异,采用Pearson相关分析25(OH)D与各代谢指标的相关性。结果2型糖尿病患者血清25(OH)D水平为3.00~46.59(15.75±0.35)μg·L^(-1),男性患者的血清25(OH)D水平显著高于女性患者(P<0.05)。2型糖尿病患者25(OH)D缺乏的患病率为74.9%(344/459),25(OH)D缺乏主要发生在1、2、3、4、11、12月份。不足组、缺乏组和严重缺乏组患者HbA1c显著高于充足组(P<0.05),缺乏组和严重缺乏组患者HbA1c显著高于不足组(P<0.05);缺乏组和严重缺乏组患者HbA1c比较差异无统计学意义(P>0.05)。充足组与不足组、缺乏组与严重缺乏组患者空腹血糖比较差异无统计学意义(P>0.05);缺乏组和严重缺乏组患者空腹血糖显著高于充足组、不足组(P<0.05)。充足组、不足组、缺乏组患者空腹胰岛素、尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值比较差异无统计学意义(P>0.05);严重缺乏组患者空腹胰岛素显著低于充足组、不足组和缺乏组,尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值显著高于充足组、不足组和缺乏组(P<0.05)。4组患者的稳态模型评估的胰岛素抵抗指数(HOMA-IR)、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙比较差异均无统计学意义(P>0.05)。Pearson相关性分析结果显示,2型糖尿病患者血清25(OH)D水平与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关(r=-0.093、-0.166、-0.157,P<0.05),与空腹胰岛素呈正相关(r=0.089,P<0.05)。2型糖尿病患者血清25(OH)D水平与空腹血糖、HOMA-IR、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙等无相关性(P>0.05)。结论2型糖尿病患者25(OH)D缺乏与不足普遍存在,女性患者缺乏更明显。2型糖尿病患者25(OH)D水平与空腹胰岛素呈正相关,与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关,25(OH)D缺乏的2型糖尿病患者主要分布在1、2、3、4、11、12月份。展开更多
Background:Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus(DM)and hypertension.Supplementing food with L-methylfolate and vitam...Background:Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus(DM)and hypertension.Supplementing food with L-methylfolate and vitamin D theoretically may improve diabetic and hypertensive retinopathy,however,the outcome of these nutritional approaches has not been fully examined.A retrospective case review was done of cases of retinopathy reversal in patients on Ocufolin^(TM) and a similar nonprescription multivitamin,Eyefolate^(TM).In this study,they were administered L-methylfolate(2.7 mg and 3.0 mg,respectively)and vitamin D3(4500 IU each).These dosages are significantly above the RDA but well below levels associated with toxicity.Case presentation:Seven patients had nonproliferative diabetic retinopathy(NPDR)and some of them had hypertension.One patient had only hypertensive retinopathy.All patients were instructed to take Ocufolin^(TM)medical food as a food supplement.Baseline genetic testing for MTHFR polymorphisms was conducted.Fundus photography was used to document the fundus condition of the enrolled eyes in 8 NPDR patients at the initial and follow-up visits.Microaneurysms(MA)and exudates were observed to be improved in some trial patients.All subjects had one or more MTHFR polymorphisms.All had diabetic retinopathy,hypertensive retinopathy,or both.MAs were resolved,and exudates were decreased in 8/8 cases after taking the medical food.Retinal edema was found in 2/8 cases and improved or resolved in both cases after taking the medical food or the supplement.The best corrected visual activity was stable or improved in 8/8 cases.Conclusion:We report a series of diabetic and hypertensive retinopathy cases with MTHFR polymorphisms and the improvement of retinal microvasculature(mainly MAs)in serial fundus photography after taking a medical food or supplement containing L-methylfolate and vitamin D.It appears that the use of nutritional supplements and medical foods containing L-methylfolate and vitamin D may be effective in facilitating the improvement of diabetic and hypertensive retinopathy.展开更多
文摘Objectives: The aim of this study was to explore the potential correlation between the GA/HbA1c ratio and diabetic retinopathy (DR) in patients with type 2 diabetes (T2D), as the GA/HbA1c ratio serves as a marker for glycemic variability. Methods: A total of 2565 T2D patients were included in this study and grouped into five categories based on the diagnostic criteria for DR. We examined the impact of the GA/HbA1c ratio on the progression of diabetes. Results: The non-DR group exhibited lower GA/HbA1c levels compared to the DR group. Additionally, as the severity of DR increased among the five groups, there was a corresponding increase in the GA/HbA1c ratio. Logistic regression analysis demonstrated that the GA/HbA1c ratio independently elevated the risk of DR occurrence. Conclusions: The GA/HbA1c ratio can independently predict the occurrence and progression of diabetic retinopathy.
文摘目的分析2型糖尿病患者25-羟维生素D[25(OH)D]水平,初步了解血清25(OH)D水平与2型糖尿病患者糖化血红蛋白(HbA1c)、胰岛功能等代谢指标的相关性。方法选择新乡市第一人民医院内分泌科2020年1月至2020年12月收治的459例2型糖尿病患者为研究对象。收集患者的临床资料,包括性别、年龄、血清25(OH)D、空腹胰岛素、C肽、HbA1c、空腹血糖、餐后血糖、尿微量白蛋白、尿白蛋白肌酐比值、血钙、血尿酸(UA)、三酰甘油(TG)、总胆固醇(TCH)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)等。根据血清25(OH)D水平将患者分为充足组[n=20,25(OH)D≥30μg·L^(-1)]、不足组[n=95,20μg·L^(-1)≤25(OH)D<30μg·L^(-1)]、缺乏组[n=231,10μg·L^(-1)≤25(OH)D<20μg·L^(-1)]、严重缺乏组[n=113,25(OH)D<10μg·L^(-1)]。比较4组患者各代谢指标的差异,采用Pearson相关分析25(OH)D与各代谢指标的相关性。结果2型糖尿病患者血清25(OH)D水平为3.00~46.59(15.75±0.35)μg·L^(-1),男性患者的血清25(OH)D水平显著高于女性患者(P<0.05)。2型糖尿病患者25(OH)D缺乏的患病率为74.9%(344/459),25(OH)D缺乏主要发生在1、2、3、4、11、12月份。不足组、缺乏组和严重缺乏组患者HbA1c显著高于充足组(P<0.05),缺乏组和严重缺乏组患者HbA1c显著高于不足组(P<0.05);缺乏组和严重缺乏组患者HbA1c比较差异无统计学意义(P>0.05)。充足组与不足组、缺乏组与严重缺乏组患者空腹血糖比较差异无统计学意义(P>0.05);缺乏组和严重缺乏组患者空腹血糖显著高于充足组、不足组(P<0.05)。充足组、不足组、缺乏组患者空腹胰岛素、尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值比较差异无统计学意义(P>0.05);严重缺乏组患者空腹胰岛素显著低于充足组、不足组和缺乏组,尿微量白蛋白、日尿白蛋白总量、尿白蛋白肌酐比值显著高于充足组、不足组和缺乏组(P<0.05)。4组患者的稳态模型评估的胰岛素抵抗指数(HOMA-IR)、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙比较差异均无统计学意义(P>0.05)。Pearson相关性分析结果显示,2型糖尿病患者血清25(OH)D水平与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关(r=-0.093、-0.166、-0.157,P<0.05),与空腹胰岛素呈正相关(r=0.089,P<0.05)。2型糖尿病患者血清25(OH)D水平与空腹血糖、HOMA-IR、血清白蛋白、血肌酐、餐后1 h血糖、餐后2 h血糖、餐后3 h血糖、空腹C肽、餐后1 h C肽、餐后2 h C肽、餐后3 h C肽、TG、TCH、LDL、HDL、血UA、血钙等无相关性(P>0.05)。结论2型糖尿病患者25(OH)D缺乏与不足普遍存在,女性患者缺乏更明显。2型糖尿病患者25(OH)D水平与空腹胰岛素呈正相关,与HbA1c、尿微量白蛋白、尿白蛋白肌酐比值呈负相关,25(OH)D缺乏的2型糖尿病患者主要分布在1、2、3、4、11、12月份。
基金Supported by NIH Center Grant P30 EY014801grant from Research to Prevent Blindness(RPB).
文摘Background:Homocysteine and vitamin D may play a role in the development of diabetic and hypertensive retinopathy in patients with diabetes mellitus(DM)and hypertension.Supplementing food with L-methylfolate and vitamin D theoretically may improve diabetic and hypertensive retinopathy,however,the outcome of these nutritional approaches has not been fully examined.A retrospective case review was done of cases of retinopathy reversal in patients on Ocufolin^(TM) and a similar nonprescription multivitamin,Eyefolate^(TM).In this study,they were administered L-methylfolate(2.7 mg and 3.0 mg,respectively)and vitamin D3(4500 IU each).These dosages are significantly above the RDA but well below levels associated with toxicity.Case presentation:Seven patients had nonproliferative diabetic retinopathy(NPDR)and some of them had hypertension.One patient had only hypertensive retinopathy.All patients were instructed to take Ocufolin^(TM)medical food as a food supplement.Baseline genetic testing for MTHFR polymorphisms was conducted.Fundus photography was used to document the fundus condition of the enrolled eyes in 8 NPDR patients at the initial and follow-up visits.Microaneurysms(MA)and exudates were observed to be improved in some trial patients.All subjects had one or more MTHFR polymorphisms.All had diabetic retinopathy,hypertensive retinopathy,or both.MAs were resolved,and exudates were decreased in 8/8 cases after taking the medical food.Retinal edema was found in 2/8 cases and improved or resolved in both cases after taking the medical food or the supplement.The best corrected visual activity was stable or improved in 8/8 cases.Conclusion:We report a series of diabetic and hypertensive retinopathy cases with MTHFR polymorphisms and the improvement of retinal microvasculature(mainly MAs)in serial fundus photography after taking a medical food or supplement containing L-methylfolate and vitamin D.It appears that the use of nutritional supplements and medical foods containing L-methylfolate and vitamin D may be effective in facilitating the improvement of diabetic and hypertensive retinopathy.