Relationship between parathyroid hormone and clinical indicators in patients with non-proliferative diabetic retinopathy
Objective To observe the changes of serum parathyroid hormone(PTH)level in patients with non-proliferative diabetic retinopathy(NPDR),and analyze its correlation with body mass index(BMI),25-hydroxyvitamin D[25(OH)D],fasting blood glucose(FBG),glycated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance index(HOMA-IR)and lipid metabolism.Methods A total of 185 patients with type 2 diabetes mellitus(T2DM)and 80 healthy physical examination people(control group)were selected in the First Affiliated Hospital of Xi'an Medical University from June 2021 to June 2022.The T2DM patients were divided into diabetic retinopathy(DR)group(both were NPDR,n=87)and non-DR group(n=98)after mydriatic fundus photography and fundus fluorescein angiography.The age and weight of the subjects were collected,as well as fasting peripheral blood.The serum PTH level of the patients was measured by electrochemiluminescence immunoassay,as well as 25(OH)D,FBG,2 h postprandial blood glucose(PBG),HAb1c,fasting insulin(FINS),2 hFINS,fasting C-peptide(FCP),2hC peptide(2 hCP),total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL),low density lipoprotein(LDL)and other indicators were measured.The changes of each index among the groups were statistically analyzed,and the correlation between PTH and each index and the relationship between PTH and DR were analyzed.Results The PTH levels in the non-DR group and DR group were(57.98±2.79)and(39.33±2.03)ng/L,lower than those in the control group[(84.73±4.82)ng/L],and the differences were statistically significant(all P＜0.01);PTH in DR group was lower than that in non-DR group,and the difference was statistically significant(P＜0.01).The levels of FBG,PBG,HbA1c,TG and 25(OH)D in non-DR group were significantly higher than those in control group,and 2 hFINS and 2 hCP were lower than those in control group,with statistical significance(all P＜0.05);The levels of FBG,PBG and HbA1c in DR group were significantly higher than those in control group,while the levels of FCP,2 hCP,TC and LDL were significantly lower than those in control group,with statistical significance(all P＜0.05).PTH level in DR group was negatively correlated with HAb1c and 25(OH)D levels(r=-0.703,-0.784;both P＜0.05),and positively correlated with TC and LDL(r=0.526,0.423;both P＜0.05).Stepwise regression analysis showed that HAblc,25(OH)D levels were significantly correlated with serum PTH level(P=0.049,0.016).Conclusions The serum PTH level in DR group was significantly decreased.Moreover,PTH is negatively correlated with HAb1c and 25(OH)D,and low PTH level may be an early indicator for predicting NPDR,which has certain reference value for predicting NPDR.
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