Cai Youran, Qiu Wanlu, Ma Xiao, Yang Yuanting, Tang Ting, Dong Yuying, Chen Jian, Zhou Qing
Department of Ophthalmology, The First Affiliated Hospital of Jinan University, No. 613, Huangpu West Road, Tianhe District, Guangzhou, 510630, Guangdong, China.
Diabetol Metab Syndr. 2025 Mar 22;17(1):95. doi: 10.1186/s13098-025-01658-z.
Diabetes retinopathy (DR) is a prevalent microvascular complication of type 2 diabetes mellitus (T2DM). This study investigated the correlation between renal function and DR, as well as the potential mediating role of the geriatric nutritional risk index (GNRI).
We classified 1122 adults with T2DM aged ≥ 40 years from the National Health and Nutrition Examination Survey database (2005-2008) into 2 groups: those with DR and those without DR. We used multivariate logistic regression analysis and restricted cubic spline (RCS) model to explore the relationship between renal function indicators and DR. Additionally, we analyzed the mediating impact of GNRI on renal function and DR.
After accounting for all covariates, the weighted multivariate analysis revealed significant associations between renal function markers and DR. Specifically, creatinine, albumin, blood urea nitrogen, and serum uric acid to creatinine ratio (SUACr) were significantly correlated with DR in serum examination, while creatinine was the only marker correlated with DR in urine. GNRI was negatively correlated with DR (odds ratio 0.94, 95% CI 0.92-0.99). Weighted linear regression showed a negative association between SUACr and GNRI (β = 0.37; 95% CI 0.12-0.62). The RCS analysis showed a nonlinear association between serum creatinine and DR (P = 0.013). GNRI mediated 14.4% of the relationship between SUACr and DR.
Our study adds to previous research by analyzing the associations between renal function indicators and DR. Furthermore, we highlight the mediating effect of GNRI, suggesting its potential utility as a predictive and treatment index for assessing renal function and DR.
糖尿病视网膜病变（DR）是2型糖尿病（T2DM）常见的微血管并发症。本研究调查了肾功能与DR之间的相关性，以及老年营养风险指数（GNRI）的潜在中介作用。
我们将来自国家健康与营养检查调查数据库（2005 - 2008年）的1122名年龄≥40岁的成年T2DM患者分为两组：患有DR的患者和未患有DR的患者。我们使用多因素逻辑回归分析和受限立方样条（RCS）模型来探讨肾功能指标与DR之间的关系。此外，我们分析了GNRI对肾功能和DR的中介影响。
在考虑所有协变量后，加权多因素分析显示肾功能标志物与DR之间存在显著关联。具体而言，血清检查中肌酐、白蛋白、血尿素氮和血清尿酸与肌酐比值（SUACr）与DR显著相关，而尿液中肌酐是与DR相关的唯一标志物。GNRI与DR呈负相关（比值比0.94，95%置信区间0.92 - 0.99）。加权线性回归显示SUACr与GNRI之间呈负相关（β = 0.37；95%置信区间0.12 - 0.62）。RCS分析显示血清肌酐与DR之间存在非线性关联（P = 0.013）。GNRI介导了SUACr与DR之间14.4%的关系。
我们的研究通过分析肾功能指标与DR之间的关联，为先前的研究增添了内容。此外，我们强调了GNRI的中介作用，表明其作为评估肾功能和DR的预测及治疗指标的潜在效用。
