协和医学杂志

2019, v.10(02) 143-147

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25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性:单中心回顾性研究
Correlation of 25-hydroxy Vitamin D and Lipoprotein-associated Phospholipase A2 with Diabetic Retinopathy: A Single-center Retrospective Study

王霖霞;苏娜;郭宁宁;白国欣;张云娜;赵晓鹏;纪桂梅;高芳;王光亚;许金秀;高瑞新;
WANG Lin-xia;SU Na;GUO Ning-ning;BAI Guo-xin;ZHANG Yun-na;ZHAO Xiao-peng;JI Gui-mei;GAO Fang;WANG Guang-ya;XU Jin-xiu;GAO Rui-xin;The Second Department of Endocrinology,Cangzhou Central Hospital;Party Committee Office,Cangzhou Central Hospital;The First Department of Ophthalmology,Cangzhou Central Hospital;

摘要(Abstract):

目的探讨25-羟维生素D[25-hydroxy vitamin D,25(OH)D]、脂蛋白相关磷脂酶A2 (lipoprotein-associated phospholipase A2,LP-PLA2)与糖尿病视网膜病变(diabetic retinopathy,DR)的相关性。方法回顾性收集并分析2014年5月至2017年1月沧州市中心医院内分泌科收治的2型糖尿病患者的临床资料,根据眼底摄片结果,分为糖尿病不伴视网膜病变组(no DR,NDR)组,背景期糖尿病伴视网膜病变(background DR,BDR)组和增殖期糖尿病伴视网膜病变(proliferative DR,PDR)组,选取同期于本院进行体检的健康人作为对照组。比较4组相关生化指标水平,采用Pearson相关分析及多元Logistic回归分析DR的相关及独立危险因素。结果共340例符合纳入和排除标准的2型糖尿病患者入选本研究,其中NDR组125例、BDR组118例、PDR组97例,对照组100例。4组间的性别、年龄、体质量指数、收缩压、舒张压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖差异无统计学意义(P均>0. 05);NDR组、BDR组、 PDR组的病程逐渐增长(P=0. 003), NDR组、 BDR组、 PDR组糖化血红蛋白A1C (glycated hemoglobin A1c,HbA1c)、糖化白蛋白(glycated albumin,GA)、血清胱抑素C (serum cystatin C,Cys-C)、LP-PLA2均显著高于健康对照组,25(OH)D显著低于健康对照组(P均<0. 05); NDR、BDR、PDR组间两两比较,Hb A1c、GA、CysC、LP-PLA2、25(OH)D差异亦有统计学意义(P均<0. 05)。Pearson相关分析显示,病程、HbA1c、GA、Cys-C及LPPLA2与DR呈正相关(P均=0. 000),25(OH)D与DR呈负相关(P=0. 000)。多元Logistic回归分析显示,病程、Hb A1c、Cys-C、LP-PLA2、25(OH)D与DR及其严重程度均独立相关(P均<0. 05)。结论 25(OH)D、LP-PLA2水平与DR的发生、发展密切相关,25(OH)D是其保护因素,而LP-PLA2是其危险因素。
Objective To investigate the correlation of 25-hydroxy vitamin D[25-(OH)D]and lipoprotein-associated phospholipase A2(LP-PLA2) with diabetic retinopathy(DR). Methods From May 2014 to January 2017,data of patients with type 2 diabetes mellitus from the Department of Endocrinology of Cangzhou Central Hospital were retrospectively analyzed and selected for the study. Patients were divided into three groups according to the results of fundus photography: type 2 diabetes mellitus without retinopathy(NDR group),background type 2 diabetic retinopathy(BDR group),and proliferative stage 2 diabetic retinopathy(PDR group),and healthy subjects who took a medical examination were selected as the control group. Relative biochemical indexes were compared among the four groups. Pearson correlation analysis and multiple Logistic regression were carried out to analyze the correlated and independent risk factors. Results Three hundred and forty type 2 diabetic patients(NDR group: 125 cases,BDR group: 118 cases,PDR group: 97 cases) and 100 healthy controls were selected for this study. There was no significant difference in sex,age,body mass index,systolic blood pressure,diastolic blood pressure,total cholesterol,triglyceride,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,and fasting blood glucose among the four groups(all P>0. 05). The course of the NDR group was shorter than that of the BDR group,and the later was shorter than that of the PDR group(P <0. 05). Compared with the control group,glycated hemoglobin A1 c(HbA1c),glycated albumin(GA),serum cystatin C(Cys-C),and LP-PLA2 were significantly higher,and 25(OH)D was significantly lower in NDR group,BDR group,and PDR group(all P<0. 05). Among the BDR group,PDR group,and NDR group,HbA1c,GA,Cys-C,LP-PLA2,and 25(OH)D also had significant differences(all P < 0. 05). After Pearson correlation analysis,the course of the disease,HbA1c,GA,Cys-C,and LP-PLA2 were positively correlated with DR(all P = 0. 000),and 25(OH)D had a negative correlation with DR(P = 0. 000). After Logistic regression analysis,the course of the disease,HbA1c,CysC,and LP-PLA2 were independent risk factors of DR,and 25(OH)D was the protective factor of DR(all P <0. 05). Conclusions 25(OH)D and LP-PLA2 levels are closely related to the occurrence and development of DR.25(OH)D is the protective factor,and LP-PLA2 is a risk factor.

关键词(KeyWords): 25-羟维生素D;脂蛋白相关磷脂酶A2;糖尿病视网膜病变
25-hydroxy vitamin D;lipoprotein-associated phospholipase A2;diabetic retinopathy

Abstract:

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基金项目(Foundation): 2016年沧州市市级指导计划(162302047)

作者(Author): 王霖霞;苏娜;郭宁宁;白国欣;张云娜;赵晓鹏;纪桂梅;高芳;王光亚;许金秀;高瑞新;
WANG Lin-xia;SU Na;GUO Ning-ning;BAI Guo-xin;ZHANG Yun-na;ZHAO Xiao-peng;JI Gui-mei;GAO Fang;WANG Guang-ya;XU Jin-xiu;GAO Rui-xin;The Second Department of Endocrinology,Cangzhou Central Hospital;Party Committee Office,Cangzhou Central Hospital;The First Department of Ophthalmology,Cangzhou Central Hospital;

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