Song Jia-Jia, Han Xiao-Fang, Chen Jian-Feng, Liu Ke-Mei
Department of Endocrinology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei 230011, Anhui Province, China.
World J Diabetes. 2023 Jul 15;14(7):1103-1111. doi: 10.4239/wjd.v14.i7.1103.
Retinopathy is the most common microvascular disease of type 2 diabetes, and seriously threatens the life, health and quality of life of patients. It is worth noting that the development of diabetic retinopathy (DR) can be hidden, with few symptoms. Therefore, the preliminary screening of diabetic patients should identify DR as soon as possible, delay disease progression, and play a vital role in its diagnosis and treatment.
To investigate the correlation between glycated hemoglobin A1c (HbA1c), urinary microalbumin (U-mALB), urinary creatinine (U-CR), mALB/U-CR ratio, β2 microglobulin (β2MG), retinol binding protein (RBP) and DR.
A total of 180 patients with type 2 diabetes mellitus attending the Second People's Hospital of Hefei from January 2022 to August 2022 were retrospectively enrolled by ophthalmologists. Based on whether they had combined retinopathy and its degree, 68 patients with diabetes mellitus without retinopathy (NDR) were assigned to the NDR group, 54 patients with non-proliferative DR (NPDR) to the NPDR group, and 58 patients with proliferative DR to the PDR group. General data, and HbA1c, mALB, β2MG, RBP, mALB/U-CR and U-CR results were collected from the patients and compared among the groups. Pearson's correlation method was used to analyze the correlation between HbA1c, mALB, β2MG, RBP, mALB/U-CR and U-CR indices, and multiple linear regression was applied to identify the risk factors for DR. Receiver operator characteristic (ROC) curves were also drawn.
The differences in age, gender, systolic and diastolic blood pressure between the groups were not statistically significantly ( > 0.05), but the difference in disease duration was statistically significant ( < 0.05). The differences in fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, and triglyceride between the groups were not statistically significant ( > 0.05). HbA1c in the PDR group was higher than that in the NPDR and NDR groups ( < 0.05). The levels of mALB, β2MG, RBP, mALB/U-CR and U-CR in the PDR group were higher than those in the NPDR and NDR groups ( < 0.05). Multiple linear regression analysis showed that disease duration, HbA1c, mALB, β2MG, RBP, mALB/U-CR and U-CR were risk factors for the development of DR. The ROC curve showed that the area under the curve (AUC) for the combination of indices (HbA1c + mALB + mALB/U-CR + U-CR + β2MG + RBP) was 0.958, with a sensitivity of 94.83% and specificity of 96.72%, which was higher than the AUC for single index prediction ( < 0.05).
HbA1c, mALB, mALB/U-CR, U-CR, β2MG and RBP can reflect the development of DR and are risk factors affecting PDR, and the combination of these six indices has predictive value for PDR.
视网膜病变是2型糖尿病最常见的微血管疾病，严重威胁患者的生命、健康和生活质量。值得注意的是，糖尿病视网膜病变（DR）的发展可能较为隐匿，症状较少。因此，对糖尿病患者进行初步筛查应尽早发现DR，延缓疾病进展，对其诊断和治疗具有至关重要的作用。
探讨糖化血红蛋白A1c（HbA1c）、尿微量白蛋白（U-mALB）、尿肌酐（U-CR）、mALB/U-CR比值、β2微球蛋白（β2MG）、视黄醇结合蛋白（RBP）与DR的相关性。
回顾性纳入2022年1月至2022年8月在合肥市第二人民医院就诊的180例2型糖尿病患者。眼科医生根据患者是否合并视网膜病变及其程度，将68例无视网膜病变的糖尿病患者（NDR）分为NDR组，54例非增殖性DR患者（NPDR）分为NPDR组，58例增殖性DR患者分为PDR组。收集患者的一般资料以及HbA1c、mALB、β2MG、RBP、mALB/U-CR和U-CR结果，并进行组间比较。采用Pearson相关分析法分析HbA1c、mALB、β2MG、RBP、mALB/U-CR和U-CR指标之间的相关性，并应用多元线性回归分析确定DR的危险因素。还绘制了受试者工作特征（ROC）曲线。
各组间年龄、性别、收缩压和舒张压差异无统计学意义（>0.05），但病程差异有统计学意义（<0.05）。各组间空腹血糖、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、总胆固醇和甘油三酯差异无统计学意义（>0.05）。PDR组的HbA1c高于NPDR组和NDR组（<0.05）。PDR组的mALB、β2MG、RBP、mALB/U-CR和U-CR水平高于NPDR组和NDR组（<0.05）。多元线性回归分析显示，病程、HbA
