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一项基于人群的病例对照研究中血脂水平升高与糖尿病视网膜病变风险之间的关联

Association Between Increased Lipid Profiles and Risk of Diabetic Retinopathy in a Population-Based Case-Control Study.

作者信息

Liu Zhenzhen, Shao Mingxi, Ren Jun, Qiu Yichao, Li Shengjie, Cao Wenjun

机构信息

Department of Clinical Laboratory, Eye and Ear Nose Throat (ENT) Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.

出版信息

J Inflamm Res. 2022 Jun 10;15:3433-3446. doi: 10.2147/JIR.S361613. eCollection 2022.

Abstract

PURPOSE

We aimed to investigate the association between lipid profiles and diabetic retinopathy (DR).

PATIENTS AND METHODS

This case-control study, which was conducted between November 2019 and August 2021, comprised 309 patients with DR, 186 patients with diabetes mellitus, and 172 healthy controls. Serum cholesterol (CHOL), triglyceride (TRIG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), small dense LDL-C (SDLDL-C), apolipoprotein A (APOA), APOB, APOE and lipoprotein (a)(LPA) levels were assessed. Patients were divided into two groups according to median age and glycated hemoglobin (HbA1c) level. Linear and logistic regression analyses were performed to assess the association between lipid levels and DR.

RESULTS

CHOL, TRIG, HDL-C, APOB, APOE, and SDLDL-C levels were significantly higher in the DR group than in the healthy control group, and TRIG levels were lower in the DR group than in the DM group (P < 0.05), especially in the ≤57-year-old and the HbA1c ≤7.2% subgroups. Linear regression analyses showed that CHOL, TRIG, APOA, APOB, APOE, and SDLDL-C levels were associated with HbA1c levels. Multivariable logistic regression analyses indicated that CHOL (odds ratio [OR] = 1.32, 95% confidence interval [CI] = 1.112-1.566), TRIG (OR = 1.269, 95% CI = 1.030-1.563), HDL-C (OR = 43.744, 95% CI = 17.12-111.769), APOB (OR = 7.037, 95% CI = 3.370-14.695), APOE (OR = 1.057, 95% CI = 1.038-1.077), and SDLDL-C (OR = 14.719, 95% CI = 8.304-26.088) levels were risk factors for DR (P < 0.05).

CONCLUSION

Increased lipid levels were risk factors for DR, and lipid level control should be strengthened, especially in younger adults or in patients with HbA1c ≤7.2%.

摘要

目的

我们旨在研究血脂谱与糖尿病视网膜病变(DR)之间的关联。

患者与方法

本病例对照研究于2019年11月至2021年8月进行,包括309例DR患者、186例糖尿病患者和172例健康对照者。评估血清胆固醇(CHOL)、甘油三酯(TRIG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、小而密低密度脂蛋白胆固醇(SDLDL-C)、载脂蛋白A(APOA)、载脂蛋白B(APOB)、载脂蛋白E(APOE)和脂蛋白(a)(LPA)水平。根据年龄中位数和糖化血红蛋白(HbA1c)水平将患者分为两组。进行线性和逻辑回归分析以评估血脂水平与DR之间的关联。

结果

DR组的CHOL、TRIG、HDL-C、APOB、APOE和SDLDL-C水平显著高于健康对照组,DR组的TRIG水平低于糖尿病组(P<0.05),尤其是在年龄≤57岁和HbA1c≤7.2%的亚组中。线性回归分析显示,CHOL、TRIG、APOA、APOB、APOE和SDLDL-C水平与HbA1c水平相关。多变量逻辑回归分析表明,CHOL(比值比[OR]=1.32,95%置信区间[CI]=1.112-1.566)、TRIG(OR=1.269,95%CI=1.030-1.563)、HDL-C(OR=43.744,95%CI=17.12-111.769)、APOB(OR=7.037,95%CI=3.370-14.695)、APOE(OR=1.057,95%CI=1.038-1.077)和SDLDL-C(OR=14.719,95%CI=8.304-26.088)水平是DR的危险因素(P<0.05)。

结论

血脂水平升高是DR的危险因素,应加强血脂水平控制,尤其是在年轻人或HbA1c≤7.2%的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68d7/9197172/fa691b00ac26/JIR-15-3433-g0001.jpg

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