[1]庞 敏,魏 祎,翁孝刚.2型糖尿病视网膜病变危险因素分析[J].新乡医学院学报,2020,37(3):270-273.[doi:10.7683/xxyxyxb.2020.03.017]
 PANG Min,WEI Yi,WENG Xiaogang.Analysis of risk factors of type 2 diabetic retinopathy[J].Journal of Xinxiang Medical University,2020,37(3):270-273.[doi:10.7683/xxyxyxb.2020.03.017]
点击复制

2型糖尿病视网膜病变危险因素分析
分享到:

《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年3
页码:
270-273
栏目:
临床研究
出版日期:
2020-03-12

文章信息/Info

Title:
Analysis of risk factors of type 2 diabetic retinopathy
作者:
庞 敏魏 祎翁孝刚
(新乡医学院第三临床学院,河南 新乡 453003)
Author(s):
PANG MinWEI YiWENG Xiaogang
(The Third Clinical College of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)
关键词:
2型糖尿病糖尿病视网膜病变三酰甘油葡萄糖指数危险因素
Keywords:
type 2 diabetes mellitusdiabetic retinopathytriglyceride glucose indexrisk factors
分类号:
R774.1
DOI:
10.7683/xxyxyxb.2020.03.017
文献标志码:
A
摘要:
目的 探讨2型糖尿病(T2DM)视网膜病变的危险因素。方法 回顾性分析2016年12月至2019年4月在新乡医学院第三附属医院就诊的208例T2DM患者的临床资料,根据无散瞳眼底彩色照相检查结果将患者分为糖尿病视网膜病变(DR)组(n=94)和无DR组(n=114),通过单因素分析T2DM视网膜病变的相关因素,采用logistic回归分析T2DM视网膜病变的危险因素,绘制受试者工作特征曲线(ROC)评估危险因素对DR的预测价值。结果 T2DM患者的三酰甘油葡萄糖(TyG)指数、三酰甘油(TG)、血尿酸、病程、收缩压与DR有关(P<0.05),患者的性别、年龄、体质量指数、血肌酐、空腹葡萄糖(FBG)、糖化血红蛋白、舒张压、低密度胆固醇、高密度胆固醇与DR无关(P>0.05)。Logistic回归分析结果显示,TyG指数、血尿酸、病程及收缩压是T2DM视网膜病变的危险因素(P<0.05)。ROC曲线分析结果显示,病程、TyG指数、收缩压、血尿酸预测T2DM发生DR的最佳截断值分别为7.5 a、4.2、138.5 mmHg(1 mmHg=0.133 kPa)、233.2 μmol·L-1 。病程、TyG指数、收缩压、血尿酸预测T2DM发生DR的曲线下面积分别为0.650、0.637、0.633、0.627,且该4个指标预测T2DM发生DR的曲线下面积比较差异无统计学意义(P>0.05)。结论 除血尿酸、病程、收缩压外,TyG指数也与T2DM视网膜病变密切相关,可作为T2DM视网膜病变的预测指标。
Abstract:
Objective To explore the risk factors of type 2 diabetic(T2DM) retinopathy.Methods The clinical data of 208 patients with T2DM in the Third Affiliated Hospital of Xinxiang Medical University from December 2016 to April 2019 were analyzed retrospectively.According to the results of fundus color photography without mydriasis,the patients were divided into diabetic retinopathy(DR) group (n=94) and non-DR group (n=114).Univariate analysis was used to analyze the related factors of T2DM retinopathy;the logistic regression was used to analyze the risk factors of T2DM retinopathy.The value of risk factors in predicting DR was evaluated by drawing subjects′ working characteristic curve (ROC).Results The triglyceride glucose (TyG) index ,triglyceride(TG) index,serum uric acid,course of disease and systolic blood pressure of patients with T2DM were related to DR(P<0.05).The results of logistic regression showed that TyG index,serum uric acid,course of disease and systolic blood pressure were the risk factors of T2DM retinopathy(P<0.05).The results of ROC curve analysis showed that the best cutoff values of course,TyG index,systolic blood pressure and serum uric acid in predicting the occurrence of DR in patients with T2DM were 7.5 years,4.2,138.5 mmHg(1 mmHg=0.133 kPa) and 233.2 μmol ·L-1 respectively.The area under ROC of course of disease,TyG index,systolic blood pressure and serum uric acid in predicting the occurrence of DR in patients with T2DM was 0.650,0.637,0.633,0.627 respectively;there was no statistic difference in the area under ROC of course of disease,TyG index,systolic blood pressure and serum uric acid in predicting the occurrence of DR in patients with T2DM.Conclusions In addition to serum uric acid,course of disease and systolic blood pressure,TyG index is also closely related to T2DM retinopathy,and it can be used as a predictive index of T2DM retinopathy.

参考文献/References:

[1] 李娜,李宝新,张云良,等.不同类型糖尿病视网膜病变患者血清和肽素和几丁质酶1水平的变化及影响因素[J].眼科新进展,2019,39(11):1044-1047,1051.
[2] PAN C,WANG S,XU C,et al.Combined effect of glycemic and blood pressure control on diabetic retinopathy among Chinese with type-2 diabetes mellitus[J].Diabetol Metab Syndr,2018,10:73-80.
[3] MELO L G N,MORALES P H,DRUMMOND K R G,et al.Current epidemiology of diabetic retinopathy in patients with type 1 diabetes:a national multicenter study in Brazil[J] .BMC Public Health,2018,18:989-998.
[4] 刘旭,王霞,何媛.糖尿病视网膜病变危险因素与预防研究进展[J].眼科新进展,2018,38(7):687-669.
[5] 李晓红,马小莉,王瑶.2型糖尿病视网膜病变与胰岛素抵抗关系的探讨[J].中华临床医师杂志:电子版,2016,40(14):2201-2202.DOI:10.3877/cma.j.issn.1674-0785.2016.14.036
[6] 朱冬立.胰岛素抵抗与糖尿病视网膜病变的相关性研究[D].大连:大连医科大学,2015.
[7] LEE S H,HAN K,YANG H K,et al.Identifying subgroups of obesity using the product of triglycerides and glucose:the Korea National Health and nutrition examination survey,2008-2010[J].Clin Endocrinol (Oxf),2015,82(2):213-220.
[8] LEE S H,KWON H S,PARK Y M,et al.Predicting the development of diabetes using the product of triglycerides and glucose:the Chungju metabolic disease cohort (CMC) study[J].PLoS One,2014,9(2):90430-90437.
[9] LI Y,YANG X F,GU H,et al.The relationship between insulin resistance/β-cell dysfunction and diabetic retinopathy in Chinese patients with type 2 diabetes mellitus:the desheng diabetic eye study[J] .Int J Ophthalmol,2018,11:493-500.
[10] ROWE C W,HAIDER A S,VISWANATHAN D,et al.Insulin resistance correlates with maculopathy and severity of retinopathy in young adults with type 1 diabetes mellitus[J] .Diabetes Res Clin Pract,2017,131:154-160.
[11] 钟南山,陆再英,陈灏珠,等.内科学[M].9版.北京:人民卫生出版社,2018:733
[12] 石新慧,任东升,陶雅非.糖尿病肾病患者血清尿酸、同型半胱氨酸水平和尿白蛋白排泄率变化及临床意义[J].新乡医学院学报,2019,36(11):1052-1054,1059.
[13] 殷为勇,王香云,肖美娟,等.甘油三酯葡萄糖指数与颅内动脉粥样硬化性狭窄的研究[J].中国现代医生,2016,54(4):18-20,24.
[14] LAAKSO M.Is insulin resistance a feature of or a primary risk factor for cardiovascular disease[J].Curr Diab Rep,2015,15 (12) :105.
[15] 王剑清,刘艳明.维生素D调控儿童肥胖、胰岛素抵抗及其机制的研究进展[J].中华实用儿科临床杂志,2015,30(20):1598-1600.
[16] IRACE C,CARALLO C,SCAVELLI F B,et al.Markers of insulin resistance and carotid atherosclerosis.A comparison of the homeostasis model assessment and triglyceride glucose index[J].Int J Clin Pract,2013,67(7):665-672.
[17] 王明夏,贾丽红,翟玲玲,等.脂肪组织内质网应激与儿童肥胖相关2型糖尿病的关系研究进展[J].中华实用儿科临床杂志,2019,34(3):231-233.
[18] 虎子颖,袁慧娟,汪艳芳,等.网膜素-1和游离脂肪酸与2型糖尿病患者外周动脉疾病的关系[J].新乡医学院学报,2017,34(8):704-708.
[19] LOCATEL J C,LOPES W A,SIMOES C F,et al.Triglyceride/glucose index is a reliable alternative marker for insulin resistance in South American overweight and obese children and adolescents[J].J Pediatr Endocrinol Metab,2019,32:1163-1170.
[20] RODRIGUEZ-MORAN M,SIMENTAL-MENDIA L E,GUERRERO-ROMERO F.The triglyceride and glucose index is useful for recognising insulin resistance in children[J] .Acta Paediatr,2017,106:979-983.
[21] CHARMOOMKIAD P,ANANCHAISARP T,WANICHANON W.The triglyceride-glucose index,a predictor of type 2 diabetes development:a retrospective cohort study[J].Prim Care Diabetes,2020,14:161-167.
[22] NAVARRO-GONZLEZ D,SANCHE-L N IGO L,PASTRANA-DELGADO J,et al.Triglyceride-glucose index (TyG index) in comparison with fasting plasma glucose improved diabetes prediction in patients with normal fasting glucose:the vascular-metabolic CUN cohort[J] .Prev Med,2016,86:99-105.
[23] 曾静波,庄晓明,穆君.血清尿酸与我国2型糖尿病患者视网膜病变的相关性研究[J].中国糖尿病杂志,2014,22(12):1079-1081.
[24] 林思耕,邓宇轩,温良,等.糖尿病视网膜病变危险因素分析[J].温州医科大学学报,2019,49(7):487-490.
[25] 张琴,杨刚毅.TyG指数对胰岛素抵抗及胰岛β细胞功能的双重评估[J].中华临床医师杂志:电子版,2014,8(2):224-228.DOI:10.3877/cma.j.issn.1674-0785.2014.02.012.

相似文献/References:

[1]翁孝刚.2型糖尿病与胰岛B一细胞功能[J].新乡医学院学报,2002,19(03):231.
[2]汪裕荣.血脂康联合小剂量阿司匹林治疗2型糖尿病并高脂血症的长期疗效观察[J].新乡医学院学报,2002,19(05):391.
[3]型糖尿病合并高血压的胰岛素敏感性探讨.2型糖尿病合并高血压的胰岛素敏感性探讨[J].新乡医学院学报,2003,20(02):124.
[4]何伟玺.冠心病与2型糖尿病患者心率变异性对比分析[J].新乡医学院学报,2003,20(04):282.
[5]李万森,毛向莹,邱培勇.2型糖尿病合并脑梗死50例临床分析[J].新乡医学院学报,2003,20(05):353.
[6]殷国田,崔瑞花.益津降糖胶囊治疗2型糖尿病42例[J].新乡医学院学报,2003,20(05):372.
[7]新乡市第二人民医院内分泌科 河南新乡.依那普利对2型糖尿病合并高血压患者血压及胰岛素敏感性指数的影响[J].新乡医学院学报,2005,22(03):267.
[8]蒋铁桥,张群,杨刚毅,等.短期胰岛素泵强化治疗对初诊2型糖尿病患者β细胞功能的影响[J].新乡医学院学报,2010,27(04):000.
[9]王润之,黄艳群.LPIN1基因的研究进展[J].新乡医学院学报,2010,27(04):413.
[10]姥勇,屈阳,朱旅云,等.脂联素与2型糖尿病血管病变的关系[J].新乡医学院学报,2011,28(01):089.

更新日期/Last Update: 2020-03-05