摘要
目的 研究糖化血红蛋白变异指数(HGI)、尿微量白蛋白(u-ALB)及血清腱生蛋白C(TNC)与2型糖尿病视网膜病变(T2DR)的相关性.方法 回顾性选择2021年4月至2023年5月于首都医科大学大兴教学医院接受治疗的2型糖尿病(T2DM)患者1 390例的临床资料,根据T2DR发生情况将其分为T2DR组(n=378)和非T2DR组(n=1 012).依据糖尿病视网膜病变早期治疗研究分类系统对T2DR患者进行分期,分为非增殖期T2DR组(n=275)和增殖期T2DR(n=103).观察两组基线资料(性别、年龄、T2DM病程)、血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)]、血脂[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇、甘油三酯]、HGI、u-ALB及血清TNC水平;观察不同T2DR病变分期患者基线资料、血糖、血脂、HGI、u-ALB、血清TNC水平.采用Pearson相关分析对T2DM患者HGI、u-ALB、血清TNC与T2DR的相关性进行分析.采用多因素Logistic回归分析对影响T2DR发生的独立危险因素进行分析.结果 T2DR组与非T2DR组的性别构成比、年龄比较,差异均无统计学意义(P＞0.05);T2DR 组 T2DM 病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC 水平均大于非T2DR组,差异均有统计学意义(P＜0.05).增殖期T2DR组与非增殖期T2DR组的性别构成比、年龄比较,差异均无统计学意义(P＞0.05);增殖期T2DR组的T2DM病程、FPG、2 h PBG、HbA1c、HDL-C、LDL-C、总胆固醇、甘油三酯、HGI、u-ALB、TNC水平均大于非增殖期T2DR组,差异均有统计学意义(P＜0.05).Pearson相关分析结果显示,HGI、u-ALB、TNC与T2DM患者发生T2DR呈正相关(P＜0.05).多因素Logistic回归分析结果显示,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素.结论 HGI、u-ALB、TNC的异常升高可促进T2DM患者T2DR的发生及进展,HbA1c、HGI、u-ALB及TNC为影响T2DM患者发生T2DR的独立危险因素.
Abstract
Objective To study the correlation of hemoglobin glycation index(HGI),urinary microalbumin(u-ALB)and serum tendi-nogenic protein C(TNC)with type 2 diabetic retinopathy(T2DR).Methods The clinical data of 1 390 type 2 diabetes mellitus(T2DM)pa-tients treated in Daxing Teaching Hospital,Capital Medical University from April 2021 to May 2023 were retrospectively selected.According to the occurrence of T2DR they were into the T2DR group(n=378)and the non-T2DR group(n=1 012).According to the research classification system for early treatment of diabetes retinopathy,T2DR patients were divided into the non proliferative T2DR group(n=275)and the prolifera-tive T2DR group(n=103).The baseline data(gender,age,duration of T2DM),the blood glucose[fasting blood glucose(FBG),2 h post-prandial blood glucose(2 h PBG)],blood lipids[high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),total cholesterol,triglycerides],HGI,u-ALB and serum TNC levels of patients in the T2DR group and the non-T2DR group were ob-served.The baseline data,blood glucose,blood lipids,HGI,u-ALB and serum TNC levels of patients with different stages of T2DR were ob-served.The correlation between HGI,u-ALB,serum TNC and T2DR in T2DM patients was analyzed by Pearson correlation.Multivariate Logis-tic regression was used to analyze the independent risk factors for T2DR in T2DM patients.Results There were no statistically significant differ-encee in gender composition ratio and age between the T2DR group and the non T2DR group(P＞0.05);the course of T2DM,FPG,2 h PBG,HbA1c,HDL-C,LDL-C,total cholesterol,triglycerides,HGI,u-ALB,and TNC levels in the T2DR group were all higher than those in the non T2DR group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in gender compo-sition ratio and age between the proliferative and T2DR group non proliferative T2DR group(P＞0.05);the course of T2DM,FPG,2 h PBG,HbA1c,HDL-C,LDL-C,total cholesterol,triglycerides,HGI,u-ALB,and TNC levels in the proliferative T2DR group were all higher than those in the non proliferative T2DR group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that HGI,u-ALB,TNC were positively correlated with T2DR in T2DM patients(P＜0.05).The results of multivariate Logistic regression analysis showed that HbA1c,HGI,u-ALB and TNC were independent risk factors for T2DR.Conclusion Abnormal elevation of HGI,u-ALB,and TNC can promote the occurrence and progression of T2DR in T2DM patients.HbA1c,HGI,u-ALB,and TNC are independent risk factors af-fecting the occurrence of T2DR in T2DM patients.
基金项目
北京市自然科学基金(2021087B)
北京市大兴区人民医院科研项目(4202321477)
维普
万方数据