Li Tiantian, Wu Yan
Department of General Practice, The First People's Hospital of Lianyungang, Lianyungang 222000, Jiangsu, China.
Emerg Med Int. 2022 Jul 21;2022:9201566. doi: 10.1155/2022/9201566. eCollection 2022.
The aim of this study was to observe the association between the development of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM) and the levels of glucose and lipid metabolism and serum uric acid (SUA) levels.
A retrospective analysis was performed on 97 patients with T2DM who were admitted to our endocrinology department from June 2019 to April 2021 with complete data; the patients were divided into DR and no DR groups (NDR) according to the presence or absence of DR. Their clinical history and biochemical test indexes were collected, and the fundus was examined by fundus photography and the fundoscopic examination method, and the vascular diameter was measured by using a computer software. All clinical data, medical history, and biochemical test indexes were compared between the two groups, and logistic regression was used to analyze the risk factors of DR.
The duration of DM disease, fasting blood glucose (FBG), glycosylated hemoglobin, type A1C (HbA1c) levels, cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), and SUA levels were higher in the DR group than those in the NDR group, and the differences were significant ( < 0.05). The difference between the NDR group and the DR group in terms of gender, age, BMI, DBP, SBP, family history of DM, FINS, and HDL-C levels was not significant ( > 0.05). The results of multifactorial analysis showed that the four variables of DM duration, HbA1c, TG, and SUA were still risk factors for the development of DR ( < 0.05). Further receiver operating characteristic (ROC) analysis showed that the areas under the curves (AUCs) for the duration of DM disease, HbA1c, TG, and SUA to predict the occurrence of DR were 0.740 (95% CI 0.639-0.841), 0.767 (95% 0.672-0.862), 0.721 (95% CI 0.617-0.826), and 0.693 (95% CI 0.588∼0.797), respectively.
The lesions of DR in T2DM patients have a close relationship with the course of DM, HbA1c, TG, and SUA, and the course of DM, HbA1c, TG, and SUA has a good predictive value for the occurrence of DR.
本研究旨在观察2型糖尿病（T2DM）患者糖尿病视网膜病变（DR）的发生与糖脂代谢水平及血清尿酸（SUA）水平之间的关联。
对2019年6月至2021年4月入住我院内分泌科且资料完整的97例T2DM患者进行回顾性分析；根据是否患有DR将患者分为DR组和无DR组（NDR）。收集他们的临床病史和生化检验指标，采用眼底照相和眼底镜检查方法检查眼底，并用计算机软件测量血管直径。比较两组的所有临床资料、病史和生化检验指标，采用逻辑回归分析DR的危险因素。
DR组的糖尿病病程、空腹血糖（FBG）、糖化血红蛋白A1C（HbA1c）水平、胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）和SUA水平均高于NDR组，差异有统计学意义（<0.05）。NDR组与DR组在性别、年龄、体重指数、舒张压、收缩压、糖尿病家族史、空腹胰岛素（FINS）和高密度脂蛋白胆固醇（HDL-C）水平方面的差异无统计学意义（>0.05）。多因素分析结果显示，糖尿病病程、HbA1c、TG和SUA这四个变量仍是DR发生的危险因素（<0.05）。进一步的受试者工作特征（ROC）分析显示，糖尿病病程、HbA1c、TG和SUA预测DR发生的曲线下面积（AUC）分别为0.740（95%CI 0.639 - 0.841）、0.767（95% 0.672 - 0.862）、0.721（95%CI 0.617 - 0.826）和0.693（95%CI 0.588∼0.797）。
T2DM患者DR的病变与糖尿病病程、HbA1c、TG和SUA密切相关，糖尿病病程、HbA1c、TG和SUA对DR的发生具有较好的预测价值。
