Zhang Xiao, Yang Jingyun, Zhong Yong, Xu Lingling, Wang Ou, Huang Ping, Li Chunying, Qu Bin, Wang Jing, Zheng Caixia, Niu Meng, Yu Weihong
Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Division of Statistics, School of Economics, Shanghai University, Shanghai, China; Research Center of Financial Information, Shanghai University, Shanghai, China; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.
Am J Med Sci. 2017 Oct;354(4):355-361. doi: 10.1016/j.amjms.2017.07.003. Epub 2017 Jul 10.
Diabetic retinopathy (DR) is a common and specific microvascular complication of diabetes. The association of bone metabolic markers with the risk of DR and diabetic macular edema (DME) is unclear.
We investigated the association between bone turnover markers commonly examined in a clinical setting and DR and DME risk in elderly Chinese patients with type 2 diabetes mellitus (T2DM). A total of 408 patients aged 55-70 years with T2DM were included. We first performed univariable logistic regression followed by multivariable logistic regression that included variables selected using purposeful selection.
Fasting blood glucose (P = 0.007) and duration of diabetes (P < 0.0001) were significantly associated with DME in multivariable logistic regression; however, the association of beta C-terminal telopeptide of collagen type I (β-CTx) with DME risk was not statistically significant (P = 0.053). Sex-stratified analysis showed that β-CTx was significantly associated with DME only in female subjects (P = 0.011).
β-CTx had no significant association with DR. It was significantly associated with DME in female patients with T2DM, but not in male patients with T2DM. More prospective studies with larger sample sizes are warranted to validate our findings.
糖尿病视网膜病变(DR)是糖尿病常见的特异性微血管并发症。骨代谢标志物与DR及糖尿病性黄斑水肿(DME)风险之间的关联尚不清楚。
我们调查了临床上常用的骨转换标志物与中国老年2型糖尿病(T2DM)患者DR及DME风险之间的关联。共纳入408例年龄在55 - 70岁的T2DM患者。我们首先进行单变量逻辑回归,然后进行多变量逻辑回归,其中包括使用有目的选择法选取的变量。
在多变量逻辑回归中,空腹血糖(P = 0.007)和糖尿病病程(P < 0.0001)与DME显著相关;然而,I型胶原β C末端肽(β - CTx)与DME风险的关联无统计学意义(P = 0.053)。按性别分层分析显示,β - CTx仅在女性受试者中与DME显著相关(P = 0.011)。
β - CTx与DR无显著关联。它在T2DM女性患者中与DME显著相关,但在T2DM男性患者中并非如此。需要更多样本量更大的前瞻性研究来验证我们的发现。