Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
Diabetes Metab J. 2011 Dec;35(6):595-601. doi: 10.4093/dmj.2011.35.6.595. Epub 2011 Dec 26.
Diabetic retinopathy is a common microvascular complication of diabetes mellitus (DM) and the leading cause of blindness in adults. Homocysteine, a risk factor with toxic effects on vascular endothelial cells, and bilirubin, a protectant with antioxidant and anti-inflammatory properties on the vasculature, have been reported to be linked to vaso-occlusive disorders. Therefore, the author of the present study investigated the association between the levels of plasma homocysteine and serum total bilirubin and the incidence of diabetic retinopathy as a chronic microvascular complication in patients with type 2 diabetes mellitus (T2DM).
A total of 102 patients with T2DM who visited our hospital from January 2009 to January 2010 were assessed.
Of the 102 patients, the prevalence of diabetic retinopathy was 67 cases (65.7%) according to clinical ophthalmic examination. The duration of DM (P<0.001), age (P=0.003), fasting blood glucose (P=0.045) and urine albumin-creatinine ratio (P=0.015) in univariate analysis and plasma homocysteine level (P=0.038), duration of DM (P=0.001), and total bilirubin level (P=0.012) in multiple logistic regression analysis were statistically significantly associated with the incidence of diabetic retinopathy.
The present study indicates that homocysteine and bilirubin may be useful biomarkers for increased risk of diabetic retinopathy since retinopathy in patients with T2DM was linked to higher plasma homocysteine level and decreased serum total bilirubin level.
糖尿病视网膜病变是糖尿病（DM）常见的微血管并发症，也是成年人失明的主要原因。同型半胱氨酸是一种对血管内皮细胞具有毒性作用的危险因素，胆红素是一种对血管具有抗氧化和抗炎作用的保护剂，两者都与血管阻塞性疾病有关。因此，本研究的作者调查了血浆同型半胱氨酸和血清总胆红素水平与 2 型糖尿病（T2DM）患者慢性微血管并发症糖尿病视网膜病变发生率之间的关系。
对 2009 年 1 月至 2010 年 1 月期间来我院就诊的 102 例 T2DM 患者进行评估。
根据临床眼科检查，102 例患者中糖尿病视网膜病变的患病率为 67 例（65.7%）。单因素分析中糖尿病病程（P<0.001）、年龄（P=0.003）、空腹血糖（P=0.045）和尿白蛋白肌酐比（P=0.015），多因素逻辑回归分析中血浆同型半胱氨酸水平（P=0.038）、糖尿病病程（P=0.001）和总胆红素水平（P=0.012）与糖尿病视网膜病变的发生率均有统计学显著相关性。
本研究表明，同型半胱氨酸和胆红素可能是糖尿病视网膜病变风险增加的有用生物标志物，因为 T2DM 患者的视网膜病变与较高的血浆同型半胱氨酸水平和较低的血清总胆红素水平有关。
