Chen Guanhua, Zhang Yuan, Wang Weimin, Jing Yali
Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, People's Republic of China.
Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 May 29;18:1801-1808. doi: 10.2147/DMSO.S518629. eCollection 2025.
Given the association between diabetic microvascular disease and bone metabolism, we aimed to investigate the correlation between the concentration of the serum bone turnover marker procollagen type I N-terminal propeptide (PINP) and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) in this study.
This was a cross-sectional study. T2DM patients aged ≥18 years were consecutively recruited from the inpatient population of the Department of Endocrinology at Nanjing Drum Tower Hospital, between January 2016 and January 2018, and participants were divided into DR and non-DR groups. We compared clinical and laboratory data of patients in the two groups. Logistic regression analysis was employed to investigate the overall risk of DR at the PINP quartiles. Receiver operating characteristic (ROC) curves were conducted to estimate the predictive power of PINP for DR.
A total of 509 patients with T2DM were included in this study (390 males and 194 females), including 148 patients with DR. Age and diabetes duration were independent risk factors for DR, PINP was also an independent protective factor (all P < 0.05). According to the interquartile range of PINP, all participants were divided into four groups. After adjustment for confounders, patients in Q2, Q3 and Q4 all had a decreased risk of DR compared with Q1 group (OR 0.501, 95% CI 0.2800.894; OR 0.289, 95% CI 0.1570.533; OR 0.077, 95% CI 0.036~0.165) respectively. Meanwhile, the AUC of DR diagnosed by the combined diagnostic model of PINP with age and duration of diabetes was 0.8271 (95% CI: 0.7911-0.863).
The PINP level is associated with diabetic retinopathy in patients with T2DM, and PINP was an independent protective factor for DR and may help to predict its progression.
鉴于糖尿病微血管病变与骨代谢之间的关联，本研究旨在探讨2型糖尿病（T2DM）患者血清骨转换标志物I型前胶原N端前肽（PINP）浓度与糖尿病视网膜病变（DR）之间的相关性。
这是一项横断面研究。2016年1月至2018年1月期间，从南京鼓楼医院内分泌科住院患者中连续招募年龄≥18岁的T2DM患者，并将参与者分为DR组和非DR组。我们比较了两组患者的临床和实验室数据。采用逻辑回归分析来研究PINP四分位数时DR的总体风险。绘制受试者工作特征（ROC）曲线以评估PINP对DR的预测能力。
本研究共纳入509例T2DM患者（男性390例，女性194例），其中148例患有DR。年龄和糖尿病病程是DR的独立危险因素，PINP也是一个独立的保护因素（所有P<0.05）。根据PINP的四分位数间距，将所有参与者分为四组。在调整混杂因素后，与Q1组相比，Q2、Q3和Q4组的患者DR风险均降低（OR分别为0.501，95%CI 0.2800.894；OR 0.289，95%CI 0.1570.533；OR 0.077，95%CI 0.036~0.165）。同时，PINP与年龄和糖尿病病程联合诊断模型诊断DR的AUC为0.8271（95%CI：0.7911-0.863）。
T2DM患者的PINP水平与糖尿病视网膜病变相关，PINP是DR的独立保护因素，可能有助于预测其进展。
