老年2型糖尿病视网膜病变与血清胆红素、胆汁酸水平的关系  

Relationship between serum bilirubin,bile acid and diabetic retinopathy in elderly patients with type 2 diabetes mellitus

作　　者：苏志燕[1] 刘薇[1] 史婷婷[1] 杨金奎[1] SU Zhi-yan;LIU Wei;SHI Ting-ting;YANG Jin-kui(Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China)

机构地区：[1]首都医科大学附属北京同仁医院内分泌科,北京市100730

出　　处：《实用老年医学》2021年第5期499-502,共4页Practical Geriatrics

摘　　要：目的研究老年T2DM病人糖尿病视网膜病变(DR)与血清胆红素、胆汁酸水平的关系。方法回顾性分析我院2018~2019年住院的363例老年T2DM病人资料,其中增殖期糖尿病视网膜病变(PDR)者153例,病史>10年且无糖尿病视网膜病变(NDR)者210例。比较2组基本临床资料、血清胆红素及胆汁酸水平;分别依据血清胆红素、胆汁酸水平将所有病人分为低、中、高水平3组,比较各组PDR发生率;采用多因素Logistic回归分析探讨DR的危险因素。结果NDR组血清胆红素、胆汁酸水平显著高于PDR组(P<0.05),TC、LDL-C、尿白蛋白排泄率(UAER)显著低于PDR组(P<0.05);随着血清胆红素、胆汁酸水平升高,PDR发生率下降;Logistic回归分析发现,胆红素及胆汁酸是DR的保护性因素,LDL-C和UAER>20μg/min是危险因素。结论老年T2DM病人血清胆红素及胆汁酸水平与DR相关,可能为保护性因素。Objective To investigate the relationship between serum bilirubin,bile acid and diabetic retinopathy(DR)in the elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 363 elderly patients with T2DM in our hospital from January 2018 to December 2019 were retrospectively collected,153 cases of them presenting with diabetic retinopathy(PDR),210 cases of them presenting with non-diabetic retinopathy(NDR)with course over 10 years.The basic clinical data,serum levels of bilirubin and bile acid of the two groups were compared.All the patients were divided into three groups according to the serum levels of bilirubin or bile acid(low,medium and high level group),and the incidence rate of PDR in each group were compared.Multivariate Logistic regression analysis was used to analyze the risk factors of DR.Result The serum levels of bilirubin and bile acid in the NDR patients were significantly higher than those in the PDR patients(P<0.05);while the levels of cholesterol,low-density lipoprotein cholesterol(LDL-C)and urinary albumin excretion rate(UAER)were significantly lower(P<0.05).The incidence rate of PDR was decreased while the serum levels of bilirubin and bile acid increased.According to the Logistic regression analysis,serum bilirubin and bile acid were protecting factors of DR,while LDL-C and UAER>20μg/min were risk factors.Conclusions In the elderly patients with T2DM,serum bilirubin and bile acid show particular relationships with DR,which may to be potential protecting factors.

关 键 词：老年人 2型糖尿病 糖尿病视网膜病变 胆红素 胆汁酸 

分 类 号：R587[医药卫生—内分泌]