摘要
目的通过测定2型糖尿病合并视网膜病变患者血清25羟维生素D_3和超敏C反应蛋白(highsensitivity C-reactive protein,hs-CRP)水平,探讨25羟维生素D_3、hs-CRP与糖尿病视网膜病变(diabetic retinopathy,DR)的关系。方法选择2型糖尿病患者560例,根据眼底照相或眼底造影分为2型糖尿病不伴视网膜病变组(NDR组,230例),2型糖尿病伴背景期视网膜病变组(BDR组,190例),2型糖尿病伴增殖期视网膜病变组(PDR组,140例)。选取同期体检的健康人140例作为对照组。收集所有研究对象临床资料,检测其血清25羟维生素D_3、hs-CRP水平。结果 4组间年龄、体重指数(body mass index,BMI)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low-density lipoprotein-cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein-cholesterol,HDL-C)差异均无统计学意义(P>0.05);NDR组、BDR组、PDR组病程、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(hemoglobin A1c,HbA1c)、hs-CRP、25羟维生素D_3与对照组差异均有统计学意义(P<0.05);BDR组、PDR组病程、FBG、HbA1c、hs-CRP、25羟维生素D_3与NDR组差异均有统计学意义(P<0.05);BDR组病程、FBG、HbA1c、hs-CRP、25羟维生素D_3与PDR组差异均有统计学意义(P<0.05)。Pearson相关分析显示,病程、FBG、HbA1c、hs-CRP与DR呈正相关(P<0.05),25羟维生素D_3与DR呈负相关(P<0.05)。Logistic回归分析显示,病程、FBG、HbA1c、hs-CRP是DR发病的独立危险因素(P<0.05)。结论 DR患者血清25羟维生素D_3明显减低,hs-CRP明显升高,与视网膜病变严重程度相关。维生素D缺乏可能通过hs-CRP导致DR发生发展。
Objective To test the level of serum 25-hydroxy vitamin D3 and high-sensitivity C-reactive protein（hs-CRP）in type 2 diabetic patients with retinopathy,and to investigate the relationship between 25-hydroxy vitamin D3,hs-CRP and type 2 diabetic retinopathy.MethodsA total of 560 cases with type 2 diabetes were selected,including type 2 diabetes mellitus without retinopathy（NDR,n=230）,type 2 diabetes with background retinopathy（BDR,n=190）,type2 diabetes with proliferative retinopathy（PDR,n=140）,140 healthy subjects were selected as control group at the same time.All clinical data were collected,serum levels of 25-hydroxy vitamin D3 and hs-CRP were determined.Results There was no significant difference in age,body mass index（BMI）,total cholesterol（TC）,triglyceride（TG）,low-density lipoproteincholesterol（LDL-C）and high-density lipoprotein-cholesterol（HDL-C）in the four groups（P〈0.05）.The duration of disease,fasting blood glucose（FBG）,hemoglobin A1 c（HbA1 c）,hs-CRP and 25-hydroxy vitamin D3 in the group of NDR,BDR and PDR were significantly different from those of the control group（P〈0.05）.The duration of disease,FBG,HbA1 c,hs-CRP,25-hydroxy vitamin D3 of the group BDR and PDR had significant difference compared to the group NDR（P〈0.05）.The duration of disease,FBG,HbA1 c,hs-CRP,25-hydroxy vitamin D3 in the group BDR were significantly different from those in the group PDR（P〈0.05）.After pearson correlation analysis,the duration of disease,FBG, HbA1 c,and hs-CRP were positively correlated with DR（P〈0.05）,and 25-hydroxy vitamin D3 was negatively correlated with DR（P〈0.01）.After logistic regression analysis,the duration of disease,FBG,HbA1 c,and hsCRP were independent risk factors of DR,and 25-hydroxy vitamin D3 was the protective factor of DR（P〈0.05）.Conclusion The serum 25-hydroxy vitamin D3 levels in patients with type 2 diabetic retinopathy were significantly decreased,hs-CRP was significantly increased.They were associated with the sev
作者
王霖霞
苏娜
张云娜
郭宁宁
王光亚
WANG Lin-xia;SU Na;ZHANG Yun-na;GUO Ning-ning;WANG Guang-ya(The Second Department of Endocrinology and Diabetes,Cangzhou Central Hospital,Hebei Province,Cangzhou 061001,China)
出处
《河北医科大学学报》
CAS
2018年第10期1149-1152,1184,共5页
Journal of Hebei Medical University
基金
沧州市科技计划项目(162302047)
