摘要
目的探究2型糖尿病患者血浆褪黑素水平与糖尿病视网膜病变(DR)的相关性,为DR的诊断提供新思路。方法前瞻性病例对照研究。收集2020年5月至10月于郑州大学第一附属医院筛查糖尿病者300人,其中体检确诊无糖尿病的健康人群为对照组(118人)、确诊为2型糖尿病并于眼科就诊的患者为研究组(182例)。根据2019年的糖尿病视网膜病变临床指南(DR PPP)进行DR的诊断和分级,结合眼底检查结果将研究组患者分为3个亚组:无DR组(NDR组,57例)、非增生型DR组(NPDR组,64例)和增生型DR组(PDR组,61例)。各组研究对象血浆褪黑素水平利用ELISA试验试剂盒进行检测,评估血浆褪黑素水平与DR风险及严重程度的关系;比较各组研究对象生化指标甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、总胆红素(Tb)及超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)、甲状旁腺激素(PTH)、25-羟基维生素D3[25(OH)VitD3]等差异。结果对照组、NDR组、NPDR组和PDR组受试者血浆褪黑素浓度分别为(72.83±16.25)ng·L^(-1)、(60.38±13.43)ng·L^(-1)、(44.48±10.30)ng·L^(-1)和(44.69±8.95)ng·L^(-1),组间差异有统计学意义(P<0.001)。而且,血浆褪黑素可作为诊断DR的潜在生物标志物(AUC=0.893,P<0.001)。所有受试者血清Tb与褪黑素含量呈显著正相关(P<0.001),NPDR组和PDR组患者血清Tb与褪黑素含量也呈显著正相关(R 2=0.360、0.183,均为P<0.001)。血清Tb、血浆hs-CRP的增高和25(OH)VitD3的降低均与DR的进展有关。不同研究组中Hcy差异有统计学意义(P<0.05)。结论DR患者血浆褪黑素浓度降低,血浆褪黑素可作为诊断DR的敏感、特异指标,且血清Tb与褪黑素浓度呈显著正相关。
Objective To explore the correlation between plasma melatonin and diabetic retinopathy(DR)in patients with type 2 diabetes to provide new ideas for the diagnosis and treatment of DR.Methods Prospective case-control study.Diabetes patients were screened in the First Affiliated Hospital of Zhengzhou University from May 2020 to October 2020,and healthy people without diabetes confirmed by physical examination were included as the control group(118 individuals).Patients diagnosed with type 2 diabetes and treated in the ophthalmology department were the study group(182 patients).According to the diabetic retinopathy preferred practice pattern(DR PPP)-updated 2019 criteria,DR was diagnosed and graded.Based on the results of fundus examination,the 182 patients were divided into 3 subgroups,including the non-DR group(NDR group,57 patients),the non-proliferating DR group(NPDR group,64 patients),and the proliferating DR group(PDR group,61 patients).The plasma melatonin level in each group was detected by ELISA kit to evaluate the relationship between plasma melatonin level and the risk and severity of DR.The differences of triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL-C),high density lipoprotein(HDL-C),total bilirubin(Tb),hypersensitive C-reactive protein(hs-CRP),homocysteine(Hcy),parathyroid hormone(PTH)and 25-hydroxyvitamin D3[25(OH)VitD3]in each group were compared.Results The plasma melatonin levels of the control group,NDR group,NPDR group and PDR group were(72.83±16.25)ng·L^(-1),(60.38±13.43)ng·L^(-1),(44.48±10.30)ng·L^(-1),and(44.69±8.95)ng·L^(-1),and the differences among groups were statistically significant(P<0.001).Besides,plasma melatonin can be used as a potential biomarker for the diagnosis of DR(AUC=0.893,P<0.001).There was a significant positive correlation between serum Tb and melatonin content in all participants(P<0.001),and there was also a significant positive correlation between serum Tb and melatonin content in NPDR group and PDR group(R 2=0.360,P<0.001).The increase of T
作者
万伟伟
龙洋
刘宏卓
万文萃
WAN Weiwei;LONG Yang;LIU Hongzhuo;WAN Wencui(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)
出处
《眼科新进展》
CAS
北大核心
2021年第5期447-451,共5页
Recent Advances in Ophthalmology
基金
河南省医学科技攻关计划省部共建青年项目(编号:SB201902008)。
