Zhu Xiaohui, Jiang Dongmei, Zhang Hongjie, Cai Ruyuan, Wang Yuying, Hua Fei
Department of Endocrinology, Affiliated Hospital 6 of Nantong University, Yancheng, 224000, People's Republic of China.
Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou, 213000, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Sep 4;17:3315-3323. doi: 10.2147/DMSO.S470297. eCollection 2024.
The study aimed to explore the correlation between retinal nerve fiber layer thickness (RNFLT) with blood biochemical indicators and cognitive dysfunction in patients with type 2 diabetes mellitus (T2DM) and the possible mechanism, thereby providing more theoretical basis for the occurrence and prevention of diabetes related complications.
Eighty T2DM patients treated in our hospital from March 2022 to September 2022 were selected as the study subjects, and the clinical data of the patients were retrospectively analyzed. All patients underwent fundus fluorescein angiography (FFA) to analyze the changes in retinal blood vessels. Patients who met the inclusion criteria were divided as the diabetic retinopathy (DR) group (n=46) and simple diabetes group (n=34). The RNFLT, blood biochemical indexes and changes in cognitive functions of the patients were detected. The correlation between RNFLT with blood biochemical indexes and cognitive dysfunction was analyzed.
Compared with the simple diabetes group, patients in the DR group had much lower mean, nasal, inferior and superior thicknesses (<0.01). There existed no significant difference in blood pressure, body mass index (BMI), blood lipids (triglycerides, cholesterol, low-density lipoprotein, high-density lipoprotein) between the two groups (>0.05). Compared with the simple diabetes group, patients in the DR group had much higher fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting insulin (FINS), insulin resistance (HOMA-IR) index, apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) (<0.001). Besides, the DR group had sharply lower scores on the Mini-Mental State Examination (MMSE) scale and higher levels of the Trail Making Test-A (TMT-A) and TMT-B (<0.001). Spearman correlation analysis confirmed that the mean RNFLT was negatively correlated with the levels of FBG, HbA1c, HOMA-IR index, TMT-A and TMT-B (<0.05), positively correlated with the score of mini-mental state examination (MMSE) (<0.05), and was no significant correlation with FINS and ApoB/ApoA1 (>0.05).
DR patients had significantly reduced RNFLT, elevated levels of blood glucose related indicators, and cognitive dysfunction. There existed a correlation between RNFLT and FBG, HbA1c, HOMA-IR index, TMT-A, TMT-B and MMSE.
本研究旨在探讨2型糖尿病（T2DM）患者视网膜神经纤维层厚度（RNFLT）与血液生化指标及认知功能障碍之间的相关性及其可能机制，从而为糖尿病相关并发症的发生及预防提供更多理论依据。
选取2022年3月至2022年9月在我院治疗的80例T2DM患者作为研究对象，对患者的临床资料进行回顾性分析。所有患者均接受眼底荧光血管造影（FFA）以分析视网膜血管变化。符合纳入标准的患者分为糖尿病视网膜病变（DR）组（n = 46）和单纯糖尿病组（n = 34）。检测患者的RNFLT、血液生化指标及认知功能变化。分析RNFLT与血液生化指标及认知功能障碍之间的相关性。
与单纯糖尿病组相比，DR组患者的平均、鼻侧、下方及上方厚度均显著降低（<0.01）。两组患者的血压、体重指数（BMI）、血脂（甘油三酯、胆固醇、低密度脂蛋白、高密度脂蛋白）比较，差异无统计学意义（>0.05）。与单纯糖尿病组相比，DR组患者的空腹血糖（FBG）、糖化血红蛋白（HbA1c）、空腹胰岛素（FINS）、胰岛素抵抗（HOMA-IR）指数、载脂蛋白B（ApoB）/载脂蛋白A1（ApoA1）水平显著升高（<0.001）。此外，DR组患者的简易精神状态检查表（MMSE）评分显著降低，连线测验A（TMT-A）和连线测验B（TMT-B）水平显著升高（<0.001）。Spearman相关性分析证实，平均RNFLT与FBG、HbA1c、HOMA-IR指数、TMT-A和TMT-B水平呈负相关（<0.05），与简易精神状态检查表（MMSE）评分呈正相关（<0.05），与FINS和ApoB/ApoA1无显著相关性（>0.05）。
DR患者的RNFLT显著降低，血糖相关指标水平升高，且存在认知功能障碍。RNFLT与FBG、HbA1c、HOMA-IR指数、TMT-A、TMT-B及MMSE之间存在相关性。
