Pramanik Subhasish, Chowdhury Subhankar, Ganguly Upasana, Banerjee Anindita, Bhattacharya Basudev, Mondal Lakshmi Kanta
Institute of Post Graduate Medical Education and Research (IPGMER), 244 Acharya Jagadish Chandra Bose Road, Kolkata, 700020, India.
ICARE Institute of Medical Sciences and Research, Haldia, 721645, India.
Heliyon. 2020 Oct 26;6(10):e05336. doi: 10.1016/j.heliyon.2020.e05336. eCollection 2020 Oct.
The present study aimed to explore the early predictive marker of diabetic retinopathy (DR) and to elucidate the associated demographic, metabolic, and ocular factors. We enrolled 43 type 2 diabetic subjects with mild non-proliferative retinopathy (MNPDR), 30 diabetic subjects with no retinopathy (DNR), and 35 healthy controls (HC). The study groups showed no significant alteration in central macular thickness (CMT) and visual acuity (VA). The contrast sensitivity (CS) score was found to be significantly lower among DNR and MNPDR subjects compared to HCs (p < 0.0001). Between MNPDR and DNR subjects, the CS score was significantly lower in the former (p = 0.0036). CS score discriminated DNR subjects from HC, with 74% accuracy for the optimal threshold 0.71. The associated area under the ROC curve (AUC) is 0.82 (p < 0.0001) while the discrimination rule has 66% sensitivity and 80% specificity. The CS score also discriminated MNPDR subjects from DNR with 64% accuracy for the optimal threshold 0.53. The associated AUC is 0.65 (p < 0.023) and the rule has 86% sensitivity and 33% specificity. According to best subset regression analysis, not only glycaemic parameters but also lipid parameters [low-density lipoprotein cholesterol (LDL-C) (p = 0.045) and triglycerides (TG) (p = 0.0005)] were found to be significant predictors of CS. CMT (p = 0.058) was another marginally significant predictor of CS. CS may be used as an early predictive marker for DR. So, not only hyperglycemia, but also hyperlipidemia seems to significantly affect retinal CS function in diabetes.
本研究旨在探索糖尿病视网膜病变（DR）的早期预测标志物，并阐明相关的人口统计学、代谢和眼部因素。我们纳入了43例患有轻度非增殖性视网膜病变（MNPDR）的2型糖尿病患者、30例无视网膜病变的糖尿病患者（DNR）和35例健康对照者（HC）。研究组的中心黄斑厚度（CMT）和视力（VA）无显著变化。与健康对照者相比，DNR和MNPDR患者的对比敏感度（CS）得分显著更低（p<0.0001）。在MNPDR和DNR患者之间，前者的CS得分显著更低（p = 0.0036）。CS得分能够区分DNR患者和健康对照者，对于最佳阈值0.71的准确率为74%。相关的ROC曲线下面积（AUC）为0.82（p<0.0001），而判别规则的敏感度为66%，特异度为80%。CS得分也能够区分MNPDR患者和DNR患者，对于最佳阈值0.53的准确率为64%。相关的AUC为0.65（p<0.023），该规则的敏感度为86%，特异度为33%。根据最佳子集回归分析，不仅血糖参数，而且血脂参数[低密度脂蛋白胆固醇（LDL-C）（p = 0.045）和甘油三酯（TG）（p = 0.0005）]均被发现是CS的显著预测因素。CMT（p = 0.058）是CS的另一个边缘显著预测因素。CS可作为DR的早期预测标志物。因此，不仅高血糖，而且高血脂似乎也会显著影响糖尿病患者的视网膜CS功能。
