糖尿病患者血清瘦素、脂联素水平与糖尿病视网膜病变不同分期的相关性研究  

Relationship between serum level of leptin, adiponectin and different stages of diabetic retinopathy in type 2 diabetes patients

作　　者：王颖[1] 佟俊旺[2] 魏剑芬[1] 陈冬[1] 吴乃君[1] 盛佳曦[1] 金秀平[1] 刘素梅[1] 

机构地区：[1]河北联合大学附属医院内分泌科,河北唐山063000 [2]河北联合大学公共卫生学院,河北唐山063000

出　　处：《中国现代医学杂志》2015年第12期73-76,共4页China Journal of Modern Medicine

摘　　要：目的探讨血清瘦素、脂联素水平与糖尿病视网膜病变的关系。方法收集河北联合大学附属医院院内分泌科住院的2型糖尿病患者120例,将其分为增殖性视网膜病变组38例,非增殖性视网膜病变组42例,糖尿病无视网膜病变组40例,另设健康对照者40例。采用放射免疫法测定血浆瘦素水平,采用酶联免疫(ELISA)定量测定脂联素水平,并于生化室检验空腹血糖、餐后2 h血糖、糖化血红蛋白、胆固醇、三酰甘油。结果病例组包括增殖性视网膜病变组、非增殖性视网膜病变组、糖尿病无视网膜病变组与对照组。血浆瘦素分别为(18.42±4.81)μg/L、(14.31±5.76)μg/L、(10.51±3.34)μg/L、(4.1±2.4)μg/L;血浆脂联素平分别为(1.34±0.75)μg/ml、(3.45±1.53)μg/ml、(5.96±1.99)μg/ml、(7.89±2.33)μg/ml。各病例组与对照组比较差异均有统计学意义(P<0.01);各病例组组间比较均差异有统计学意义(P<0.01);血浆瘦素水平与年龄、空腹血糖、餐后2h血糖、糖化血红蛋白、胆固醇、三酰甘油等无相关关系。直线相关分析表明:血浆瘦素水平与体重指数呈正相关。血清瘦素、脂联素水平与视网膜病变的相关性分析,随着DM病程的延长及视网膜受损程度与瘦素水平呈正相关(F=0.543,P<0.01),与脂联素水平呈正负相关(F=0.428,P<0.01)。结论血浆瘦素、脂联素水平是2型糖尿病视网膜病变发病的一种独立危险因子,且血浆瘦素增高的幅度与病情的严重程度正相关,脂联素水平减低的幅度与病情的严重程度负相关。为糖尿病视网膜病变的早期干预治疗提供了新思路。[Objective] To evaluate the relationship between serum levels of leptin, adiponectin and diabetic retinopathy in type 2 diabetes patients. [Methods]Leptin, adiponectin, FBG, PBG, HBA1 C, CHOL, TG and other clinical characteristics were tested in 120 type 2 diabetes patients and 40 control cases（control group）. The diabetes patients were divided into three groups： non-diabetic retinopathy（group NDR）, non-proliferative diabetic retinopathy（group NPDR） and proliferative diabetic retinopathy（group PDR） according to the examination of fundus. Correlations between levels of serum leptin, adiponectin and other parameters were analyzed. [Results]Plasma levels of leptin in the groups NDR, NPDR, PDR and control group were（18.42 ± 4.81） μg/l,（14.31 ± 5.76） μg/l,（10.51 ±3.34） μg/l and（4.1 ± 2.4） μg/l, respectively. Plasma levels of adiponectin in the groups NDR, NPDR, PDR and control group were（1.34 ± 0.75 μg/ml）,（3.45 ± 1.53） μg/ml,（5.96 ± 1.99） μg/ml and（7.89 ± 2.33） μg/ml, respectively.There were significant differences in both leptin and adiponectin levels between each diabetic group and the control group（P〈0.01） and among different diabetic groups（P〈0.01）. The serum leptin level was positively correlated with BMI. The serum leptin level was positively correlated with development of diabetic retinopathy（F = 0.543,P〈0.01）, the serum adiponectin level was negatively correlated with development of diabetic retinopathy（F = 0.428,P〈0.01）. [Conclusions] Serum leptin level is elevated and adiponectin level is declined in patients with diabetic retinopathy which are closely related with the development of diabetic retinopathy.

关 键 词：糖尿病视网膜病变 瘦素 脂联素 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]