血糖、血脂水平与糖尿病视网膜病变患者视力损害的相关性研究
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摘要
目的探讨血糖、血脂水平与糖尿病视网膜病变患者视力损害的相关性。方法选取2016年1月至2018年1月我院内分泌科收治的250例DR患者进行研究。根据视力分级标准分为三个组:盲组(n=28),低视力组(n=80),低视力以上组(n=142)。比较各组患者FPG、HbAlC、TC、TG、LDL-C、HDL-C、LDL-C/HDL-C、ApoB、ApoA1、ApoB/ApoA1水平,对FPG、HbA1C、LDL-C/HDL-C及ApoB/ApoA1与DR患者视力损害进行Pearman相关性分析和Logistic回归分析。结果三组患者的TC、TG差异均无统计学意义(P>0.05);与低视力以上组相比,盲组和低视力组FPG、HbAlC、LDL-C、LDL-C/HDL-C、ApoB、ApoB/ApoA1更高,HDL-C、ApoA1更低(P<0.05);盲组FPG、HbAlC、LDL-C、LDL-C/HDL-C、ApoB、ApoB/ApoAl显著高于低视力组,HDL-C、ApoA1显著低于低视力组(P<0. 05)。经Spearman相关性分析,FPG、HbAlC、LDL-C/HDL-C、ApoB/ApoA1比值与DR患者视力损害均呈正相关。经Logistic回归分析,FPG、HbAlC、LDL-C/HDL-C、ApoB/ApoA1均是DR患者视力损害的独立危险因素。结论 FPG、HbAlC、LDL-C/HDL-C、ApoB/ApoA1与DR患者的视力损害有密切关系,通过监测这些指标有利于DR患者视力损害的预测,及时采取治疗措施。
Objective To investigate the correlation between blood glucose, blood lipid levels and visual impairment in diabetic retinopathy(DR). Methods 250 patients with DR were selected from January,2016 to January,2018. According to the criteria of visual acuity classification,they were divided into three groups:blind group(n = 28), low vision group( n = 80) and superior to low vision group(n = 142). The FPG,HbAlC,TC,TG,LDL-C,HDL-C,LDL-C/HDL-C, ApoB,ApoAl,and ApoB/ApoA1 levels of each group were compared, Spearman correlation analysis and logistic regression analysis of visual impairment between FPG,HbAlC, LDL-C/HDL-C, ApoB/ApoA1 and DR patients were carried out. Results There were no significant differences in TC and TG among the three groups(P >0.05). Compared with the low vision group,levels of FPG,HbAlC,LDL-C,LDL-C/HDL-C,ApoB,ApoB/ApoA1 were higher in the blind group and the superior to low vision group, while HDL-C, ApoA1 were lower(P < 0.05). Levels of FPG, HbAlC,LDL-C, LDL-C/HDL-C, ApoB, and ApoB/ApoAl in the blind group were higher than the low vision group,while HDL-C,ApoA1 were lower than the low vision group(P <0.05). Pearson correlation analysis showed that the ratio of FPG, HbAlC,LDL-C/HDL-C,and ApoB/ApoA1 were positively correlated with visual impairment in DR patients. Based on logistic regression analysis,levels of FPG,HbAlC,LDL-C/HDLC and ApoB/ApoAl were independent risk factors for visual impairment in DR patients. Conclusion There is a close relationship between levels of FPG,HbAlC,LDL-C/HDL-C, ApoB/ApoA1 and visual impairment in DR patients. It is useful to predict the visual impairment of DR patients by monitoring these indexes and carry out treatment measures in time.
Objective To investigate the correlation between blood glucose, blood lipid levels and visual impairment in diabetic retinopathy(DR). Methods 250 patients with DR were selected from January,2016 to January,2018. According to the criteria of visual acuity classification,they were divided into three groups:blind group(n = 28), low vision group( n = 80) and superior to low vision group(n = 142). The FPG,HbAlC,TC,TG,LDL-C,HDL-C,LDL-C/HDL-C, ApoB,ApoAl,and ApoB/ApoA1 levels of each group were compared, Spearman correlation analysis and logistic regression analysis of visual impairment between FPG,HbAlC, LDL-C/HDL-C, ApoB/ApoA1 and DR patients were carried out. Results There were no significant differences in TC and TG among the three groups(P >0.05). Compared with the low vision group,levels of FPG,HbAlC,LDL-C,LDL-C/HDL-C,ApoB,ApoB/ApoA1 were higher in the blind group and the superior to low vision group, while HDL-C, ApoA1 were lower(P < 0.05). Levels of FPG, HbAlC,LDL-C, LDL-C/HDL-C, ApoB, and ApoB/ApoAl in the blind group were higher than the low vision group,while HDL-C,ApoA1 were lower than the low vision group(P <0.05). Pearson correlation analysis showed that the ratio of FPG, HbAlC,LDL-C/HDL-C,and ApoB/ApoA1 were positively correlated with visual impairment in DR patients. Based on logistic regression analysis,levels of FPG,HbAlC,LDL-C/HDLC and ApoB/ApoAl were independent risk factors for visual impairment in DR patients. Conclusion There is a close relationship between levels of FPG,HbAlC,LDL-C/HDL-C, ApoB/ApoA1 and visual impairment in DR patients. It is useful to predict the visual impairment of DR patients by monitoring these indexes and carry out treatment measures in time.
引文
[1]韩昌婧,郑志.血脂紊乱与糖尿病视网膜病变相关性研究现状与进展[J].中华眼底病杂志,2016,32(2):210-212.
[2]张凤俊,易敬林,李晶明,等.糖尿病视网膜病变发病机制研究进展[J].眼科新进展,2016,36(6):584-587.
[3]王海敏,田德增,丁亚莉,等.血清载脂蛋白B、甘油三酯、脂蛋白a和转铁蛋白与2型糖尿病视网膜病变的相关性研究[J].中国糖尿病杂志,2017,25(8):716-719.
[4]郭冉阳.血脂代谢及视网膜中央动脉血流动力学与糖尿病视网膜病变的相关性研究[J].海南医学院学报,2016,22(18):2185-2187.
[5] SIERA-JOHNSON J,ROMERO-CORAL A, SOMERS V K,et al.ApoB/ApoA-I ratio:an independent predictor of insulin resistance in U S non-diabetic subjects[J]. Eur Heart J,2007,28(21):2637-2643.
[6]蒋海霞.血清载脂蛋白与脂蛋白联合检测对2型糖尿病的诊断意义[J].检验医学与临床,2014,11(24):3467-3468.
[7]陈学军.糖尿病血管并发症患者血清ApoA1、ApoB检测水平及其比值分析[J]·中国实验诊断学,2016,20(3):412-415.
[8]张俊防,姚海延,周洪跃,等.2型糖尿病患者胰岛素原与载脂蛋白B/载脂蛋白A1比值的关系[J].广东医学,2013,34(24):3776-3778.
[9]马长红,田永霞,李鸿雁,等.糖尿病视网膜病变患者血脂和动态血压变化特点[J].中国临床医生杂志,2016,44(12):45-47.
[10] SASAKI M, KAWASAKI R, NOONAN I E, et al. Quantitative Measurement of Hard Exudates in Patients With Diabetes and Their Associations With Serum Lipid Levels[J]. Invest Ophthalmol Vis Sic,2013,54(8):5544-5550.
[11]赵军明,柳亚娟,陈蜀敏,等.载脂蛋白B/载脂蛋白A1比值与2型糖尿病视网膜病变的相关性分析[J].糖尿病新世界,2016,19(3);136-138.
[12] DEGUCHI Y,MAENO T,SAISHIN Y,et al. Relevance of the serum apolipoprotein ratio to diabetic retinopathy[J]. Jpn J Ophthalmol,2011,55(2):128-131.
[13]耿倩,高永峰,董玲芳,等.早期2型糖尿病视网膜病变与血清apoB/apoAl的关系[J].河南医学研究,2014,23(1):13-16.
[14] KAWAI S,NAKAJIMA T, HOKARI S,et al. Apolipoprotein A-I concentration in tears in diabetic retinopathy[J]. Ann Clin Biochem,2002,39(Pt 1):56-61.
[15] SASONGKO M B, WONG T Y, NAUYEN T T, et al. Serum apolipoprotein AI and B are stronger biomarkers of diabetic retinopathy than traditional lipids[J]. Diabetes Care,2011,34(2):474-479.
[2]张凤俊,易敬林,李晶明,等.糖尿病视网膜病变发病机制研究进展[J].眼科新进展,2016,36(6):584-587.
[3]王海敏,田德增,丁亚莉,等.血清载脂蛋白B、甘油三酯、脂蛋白a和转铁蛋白与2型糖尿病视网膜病变的相关性研究[J].中国糖尿病杂志,2017,25(8):716-719.
[4]郭冉阳.血脂代谢及视网膜中央动脉血流动力学与糖尿病视网膜病变的相关性研究[J].海南医学院学报,2016,22(18):2185-2187.
[5] SIERA-JOHNSON J,ROMERO-CORAL A, SOMERS V K,et al.ApoB/ApoA-I ratio:an independent predictor of insulin resistance in U S non-diabetic subjects[J]. Eur Heart J,2007,28(21):2637-2643.
[6]蒋海霞.血清载脂蛋白与脂蛋白联合检测对2型糖尿病的诊断意义[J].检验医学与临床,2014,11(24):3467-3468.
[7]陈学军.糖尿病血管并发症患者血清ApoA1、ApoB检测水平及其比值分析[J]·中国实验诊断学,2016,20(3):412-415.
[8]张俊防,姚海延,周洪跃,等.2型糖尿病患者胰岛素原与载脂蛋白B/载脂蛋白A1比值的关系[J].广东医学,2013,34(24):3776-3778.
[9]马长红,田永霞,李鸿雁,等.糖尿病视网膜病变患者血脂和动态血压变化特点[J].中国临床医生杂志,2016,44(12):45-47.
[10] SASAKI M, KAWASAKI R, NOONAN I E, et al. Quantitative Measurement of Hard Exudates in Patients With Diabetes and Their Associations With Serum Lipid Levels[J]. Invest Ophthalmol Vis Sic,2013,54(8):5544-5550.
[11]赵军明,柳亚娟,陈蜀敏,等.载脂蛋白B/载脂蛋白A1比值与2型糖尿病视网膜病变的相关性分析[J].糖尿病新世界,2016,19(3);136-138.
[12] DEGUCHI Y,MAENO T,SAISHIN Y,et al. Relevance of the serum apolipoprotein ratio to diabetic retinopathy[J]. Jpn J Ophthalmol,2011,55(2):128-131.
[13]耿倩,高永峰,董玲芳,等.早期2型糖尿病视网膜病变与血清apoB/apoAl的关系[J].河南医学研究,2014,23(1):13-16.
[14] KAWAI S,NAKAJIMA T, HOKARI S,et al. Apolipoprotein A-I concentration in tears in diabetic retinopathy[J]. Ann Clin Biochem,2002,39(Pt 1):56-61.
[15] SASONGKO M B, WONG T Y, NAUYEN T T, et al. Serum apolipoprotein AI and B are stronger biomarkers of diabetic retinopathy than traditional lipids[J]. Diabetes Care,2011,34(2):474-479.