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糖尿病患者尿免疫球蛋白M排泄与糖尿病视网膜病变之间的关联。

The association between urinary lgM excretion and diabetic retinopathy in diabetic patients.

作者信息

Sanjari Mojgan, Asadikaram Gholam Reza, Beigzadeh Fariba, Torabian Soheila, Safi Zohreh, Ghaseminejad Tafreshi Amirfarhad

机构信息

Endocrinology and metabolism Research Center, Institute of Basic and clinical physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.

Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran.

出版信息

J Diabetes Metab Disord. 2016 Jun 29;15:18. doi: 10.1186/s40200-016-0242-x. eCollection 2015.

Abstract

BACKGROUND

Diabetic Retinopathy is one of the most common causes of blindness among adults. Microvascular complications may have common origins. The objective of the present study is to analyze the correlation between urinary IgM excretion and diabetic retinopathy based on the type of diabetes.

METHODS

The present study is cross-sectional analytic and was carried out on 140 type2 diabetic patients (of which 70 patients diagnosed with retinopathy) and 76 type1 diabetic patients (of which 37 patients diagnosed with retinopathy). For every patient in each of the test groups, fasting plasma glucose, triglyceride, cholesterol, creatinin and HbA1c tests were done. The value of IgM, the albumin- to- creatinine ratio and the urine analysis test were also used to rule out the significant proteinuria of the patients. Then, IgM Index was measured using the following equation: Igm Index = Urine IgM/Urine Cr.

RESULTS

The level of IgM index in the diabetic patients (type1 and type2) had no significant correlation with retinopathy. Cut point = 1.49, sensitivity = 0.703 and specificity = 0.308 in type1 diabetes were used for screen retinopathy. In type1 diabetic patients, the duration of diabetes had a significant correlation with urinary protein while in type 2 diabetic patients, the diabetes duration and HbA1c were significantly correlated with retinopathy.

CONCLUSION

The results of this study demonstrate that the level of urinary IgM in diabetic patients has no difference in those who have or lack retinopathy, but the urinary IgM level of more than 1.49 mg/dl can be considered as a cut point in type1 diabetic patients to screen retinopathy.

摘要

背景

糖尿病视网膜病变是成年人失明的最常见原因之一。微血管并发症可能有共同的起源。本研究的目的是根据糖尿病类型分析尿IgM排泄与糖尿病视网膜病变之间的相关性。

方法

本研究为横断面分析,对140例2型糖尿病患者(其中70例诊断为视网膜病变)和76例1型糖尿病患者(其中37例诊断为视网膜病变)进行了研究。对每个测试组中的每位患者进行空腹血糖、甘油三酯、胆固醇、肌酐和糖化血红蛋白测试。IgM值、白蛋白与肌酐比值和尿液分析测试也用于排除患者的显著蛋白尿。然后,使用以下公式测量IgM指数:IgM指数=尿IgM/尿肌酐。

结果

糖尿病患者(1型和2型)的IgM指数水平与视网膜病变无显著相关性。1型糖尿病中,切点=1.49,敏感性=0.703,特异性=0.308,用于筛查视网膜病变。在1型糖尿病患者中,糖尿病病程与尿蛋白显著相关,而在2型糖尿病患者中,糖尿病病程和糖化血红蛋白与视网膜病变显著相关。

结论

本研究结果表明,糖尿病患者中有无视网膜病变者的尿IgM水平无差异,但尿IgM水平超过1.49mg/dl可作为1型糖尿病患者筛查视网膜病变的切点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18a4/4928287/3fc38d8900f3/40200_2016_242_Fig1_HTML.jpg

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