2型糖尿病视网膜病变与视黄醇结合蛋白4的相关性  

The correlation between diabetic retinopathy and serum retinol binding protein 4 in type 2 diabetes

作　　者：江帆[1] 李裕明[2] 邓波[2] 陈璐璐[2] 

机构地区：[1]海南省人民医院老年病科,海南海口570311 [2]华中科技大学同济医学院附属协和医院内分泌科,湖北武汉430022

出　　处：《热带医学杂志》2013年第9期1075-1077,1094,共4页Journal of Tropical Medicine

基　　金：湖北省卫生厅科研基金(JX3A04);湖北省科技攻关计划(2007AA302B04)

摘　　要：目的探讨2型糖尿病(T2DM)合并糖尿病视网膜病变(DR)患者发病的危险因素以及视网膜病变严重程度与血清视黄醇结合蛋白4(RBP4)水平的相关性。方法选择2007年10月至2010年8月在武汉协和医院内分泌科就诊的T2DM患者300例,所有入选患者接受常规生化检查,均行葡萄糖耐量试验;采取免散瞳眼底拍照检查DR,若有异常由眼科医师进行散瞳后行眼底镜检查。所有患者均留取标本检测24 h尿微量白蛋白(UAL)。留取血清标本采用ELISA测定RBP4。结果影响DR的因素依次为年龄、糖尿病患病时间、腰臀比(WHR)、高密度脂蛋白(HDL)、空腹胰岛素(FINS)、UAL和胰岛素抵抗指数(HOMA-IR)(P<0.01);RBP4水平与HOMA-IR、UAL、FINS呈正相关,与HDL负相关;T2DM无视网膜病变组(NDR组)与T2DM合并背景性视网膜病变组(BDR组)之间血清RBP4差异无统计学意义,T2DM合并增殖性视网膜病变组(PDR组)RBP4水平高于NDR组(P<0.001)和BDR组(P<0.05)。结论血清RBP4水平与DR及胰岛素抵抗密切相关,并与增殖性视网膜病变的发生发展呈正相关。Objective To investigate risk factors of diabetic retinopathy and the associations between retinol binding protein （RBP4） and the severity of diabetic retinopathy in type 2 diabetic patients. Methods A total of 300 T2DM patients were recruited from the outpatients and inpatients of the Endocrinology Department at Union Hospital during the period between October 2007 and August 2010. All selected patients were received routine biochemistry test and OGTT. Non-mydriatic fundus camera screening was used as a tool to identify diabetic retinopathy. If abnormality is detected, it will be confirmed by direct ophthalmoscopy after papillary dilatation. Serum RBP4 will be determined by ELISA. Results Factors involved in diabetic retinopathy were age, duration since the disease was diagnosed, waist-to-hipratio （WHR）, urinary albumin （UAL）, insulin resistance index （HOMA-IR）, high density lipoprotein （HDL）, and fasting insulin （FBG）（P〈O.O1）. The level of serum RBP4 was positively correlated with HOMA-IR, UAL, and FINS, but negatively correlated with HDL. There were no differences of RBP4 levels between the NDR and BDR group. But RBP4 level of PDR was higher than that of NDR （P〈0.001）and BDR （P〈0.05）. Conclusion The serum RBP4 level was relevant to diabetic retinopathy and insulin resistance, and was positively correlated with the development of PDR.

关 键 词：糖尿病视网膜病变 视黄醇结合蛋白4 2型糖尿病 

分 类 号：R774.1[医药卫生—眼科]