Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
J Diabetes Investig. 2023 May;14(5):675-685. doi: 10.1111/jdi.13997. Epub 2023 Feb 22.
This cross-sectional study assessed the association of serum dehydroepiandrosterone levels with the risk of diabetic retinopathy in patients with type 2 diabetes mellitus in China.
Patients with type 2 diabetes mellitus were included in a multivariate logistic regression analysis to assess the association of dehydroepiandrosterone with diabetic retinopathy after adjusting for confounding factors. A restricted cubic spline was also used to model the association of serum dehydroepiandrosterone level with the risk of diabetic retinopathy and to describe the overall dose-response correlation. Additionally, an interaction test was conducted in the multivariate logistic regression analysis to compare the effects of dehydroepiandrosterone on diabetic retinopathy among age, sex, obesity status, hypertension, dyslipidemia, and glycosylated hemoglobin level subgroups.
In total, 1,519 patients were included in the final analysis. Low serum dehydroepiandrosterone was significantly associated with diabetic retinopathy in patients with type 2 diabetes mellitus after adjustment for confounding factors (odds ratio [quartile 4 vs quartile 1]: 0.51; 95% confidence interval: 0.32-0.81; P = 0.012 for the trend). Additionally, the restricted cubic spline indicated that the odds of diabetic retinopathy decreased linearly as the dehydroepiandrosterone concentration increased (P-overall = 0.044; P-nonlinear = 0.364). Finally, the subgroup analyses showed that the dehydroepiandrosterone level stably affected diabetic retinopathy (all P for interaction >0.05).
Low serum dehydroepiandrosterone levels were significantly associated with diabetic retinopathy in patients with type 2 diabetes mellitus, suggesting that dehydroepiandrosterone contributes to the pathogenesis of diabetic retinopathy.
本横断面研究评估了血清脱氢表雄酮水平与中国 2 型糖尿病患者糖尿病视网膜病变风险的关系。
将 2 型糖尿病患者纳入多变量逻辑回归分析,以调整混杂因素后评估脱氢表雄酮与糖尿病视网膜病变的关系。还使用受限立方样条来模拟血清脱氢表雄酮水平与糖尿病视网膜病变风险的关联,并描述总体剂量-反应相关性。此外,在多变量逻辑回归分析中进行了交互检验,以比较脱氢表雄酮对年龄、性别、肥胖状况、高血压、血脂异常和糖化血红蛋白水平亚组中糖尿病视网膜病变的影响。
共纳入 1519 例患者进行最终分析。调整混杂因素后,低血清脱氢表雄酮与 2 型糖尿病患者的糖尿病视网膜病变显著相关(优势比[四分位 4 与四分位 1]:0.51;95%置信区间:0.32-0.81;趋势 P=0.012)。此外,受限立方样条表明,随着脱氢表雄酮浓度的增加,糖尿病视网膜病变的几率呈线性下降(P 总=0.044;P 非线性=0.364)。最后,亚组分析显示,脱氢表雄酮水平稳定影响糖尿病视网膜病变(所有交互检验 P 值均>0.05)。
低血清脱氢表雄酮水平与 2 型糖尿病患者的糖尿病视网膜病变显著相关,表明脱氢表雄酮参与了糖尿病视网膜病变的发病机制。