Study on the relationship between serum GPER1,SESN2 levels and diabetes retinopathy in patients with type 2 dia-betes
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维普
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目的 研究2型糖尿病(T2DM)患者血清G蛋白偶联雌激素受体1(GPER1)、应激诱导蛋白2(SESN2)水平与糖尿病视网膜病变(DR)的关系.方法 回顾性选取2020年2月-2022年2月联勤保障部队第九四○医院眼科诊治的T2DM患者162例为T2DM组.根据眼部检查结果,将T2DM患者分为DR亚组(n=68)和非DR亚组(n=94);根据DR病情程度,将DR患者分为增生性亚组(n=28)和非增生性亚组(n=40).另选取同期医院健康体检者60例为健康对照组.采用酶联免疫吸附试验检测血清GPER1、SESN2水平;多因素Logistic回归分析DR的影响因素;受试者工作特征(ROC)曲线评价血清GPER1、SESN2水平对DR的预测价值.结果 T2DM组血清GPER1水平高于健康对照组,血清SESN2水平低于健康对照组(t/P=36.850/＜0.001,28.112/＜0.001);DR亚组糖尿病病程、胰岛素抵抗指数(HOMA-IR)、血清GPER1高于非DR亚组,肾小球滤过率(eGFR)、血清SESN2低于非DR亚组(t/P=11.552/＜0.001,3.078/0.009,17.226/＜0.001,21.915/＜0.001,11.100/＜0.001);增生性 DR 亚组血清GPER1水平高于非增生性DR亚组,血清SESN2水平低于非增生性DR亚组(t/P=12.151/＜0.001,3.534/＜0.001);多因素Logistic回归结果示,糖尿病病程长、HOMA-IR高、GPER1高是DR的独立危险因素[OR(95％CI)=1.237(1.096～1.397),1.265(1.079～1.483),1.347(1.054～1.721)],eGFR 高、SESN2 高是 DR 的独立保护因素[OR(95％CI)=0.736(0.598～0.906),0.759(0.596～0.967)];血清 GPER1、SESN2 水平及二者联合预测 DR 的曲线下面积(AUC)分别为0.731、0.710、0.820,二者联合的AUC大于血清GPER1、SESN2水平单独预测(Z=4.711、4.816,P均＜0.001).结论 DR患者血清GPER1升高,SESN2降低,两者均参与DR的发生发展,两者联合检测对DR的发生具有较高的预测价值.
Objective To study the relationship between serum G protein coupled estrogen receptor 1(GPER1),sestrin 2(SESN2)levels and diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 162 patients with T2DM diagnosed and treated in the 940 Hospital of Joint Logistics Support Force from February 2020 to February 2022 were retrospectively selected as the T2DM group.According to the results of eye examination,T2DM pa-tients were divided into DR subgroup(n=68)and non-DR subgroup(n=94).According to the severity of DR,DR patients were divided into proliferative subgroup(n=28)and non-proliferative subgroup(n=40).60 cases of healthy physical exami-nation in the same period were selected as the healthy control group.The levels of serum GPER1 and SESN2 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to analyze the influencing fac-tors of DR;the predictive value of serum GPER1 and SESN2 levels for DR was evaluated by receiver operating characteristic(ROC)curve.Results The serum GPER1 level in the retinopathy group was higher than that in the healthy control group,and the serum SESN2 level was lower than that in the healthy control group(t/P=36.850/＜0.001,28.112/＜0.001);the inci-dence of DR in 162 patients was 41.96％(68/162).The duration of diabetes,insulin resistance index(HOMA-IR)and serum GPER1 in DR subgroup were higher than those in non-DR subgroup,while glomerular filtration rate(eGFR)and serum SESN2 were lower than those in non-DR subgroup(t/P=1 1.552/＜0.001,3.078/0.009,17226/＜0.001,21.915/＜0.001,11.100/＜0.001).The serum GPER1 level in the proliferative DR subgroup was higher than that in the non-proliferative DR sub-group,and the serum SESN2 level was lower than that in the non-proliferative DR subgroup(t/P=12.151/＜0.001,3.534/＜0.001);Multivariate Logistic regression results showed that long duration of diabetes,high HOMA-IR and high GPER1 were independent risk factors for DR[OR(95％CI)=1237(1.096-1.397),1265(1.079-1.483),1347(1.054-1.721)],and high eGFR and SESN2 were independent protective factors for DR[OR(95％CI)=0.736(0.598-0.906),0.759(0.596-0.967)];The area un-der the curve(AUC)of serum GPER1,SESN2 levels and the combination of the two for predicting DR were 0.731,0.710 and 0.820,respectively.The AUC of the combination of the two was greater than that of serum GPER1 and SESN2 levels alone(Z=4.711,4.816,P＜0.001).Conclusion Serum GPER1 increases and SESN2 decreases in DR patients.Both of them are in-volved in the occurrence and development of DR.The combination of the two has a high predictive value for the occur-rence of DR.
Type 2 diabetesDiabetes retinopathyGprotein coupled estrogen receptor 1Sestrin 2Influencing fac-torPredictive value
维普
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