2型糖尿病患者血红蛋白水平降低增加视网膜病变风险  

Low hemoglobin levels are associated with increased risk of diabetic retinopathy in type 2 diabetes

作　　者：付令利[1] 李文君[1] 苏龙[2] 孙蓓[1] Fu Lingli;Li Wenjun;Su Long;Sun Bei(NHC Key Laboratory of Hormones and Development,Tianjin Key Laboratory of Metabolic Diseases,Chu Hsien-I Memorial Hospital&Tianjin Medical University,Tianjin Institute of Endocrinology,Tianjin Medical University,Tianjin 300134,China;Department of Ophthalmology,The Second Hospital of Tianjin Medical University,Tianjin Institute of Orbital Disease,Tianjin 300211,China)

机构地区：[1]天津医科大学朱宪彝纪念医院眼科、天津市内分泌研究所、卫健委激素与发育重点实验室,天津市代谢性疾病重点实验室,300134 [2]天津医科大学第二医院眼科,天津市眼眶病研究所,300211

出　　处：《中华眼底病杂志》2021年第7期528-532,共5页Chinese Journal of Ocular Fundus Diseases

基　　金：天津市自然科学基金(18JCZDJC35500);天津医科大学朱宪彝纪念医院科研基金(2019ZDKF06)。

摘　　要：目的观察2型糖尿病(T2DM)患者血红蛋白(Hb)水平变化及其与糖尿病视网膜病变(DR)的相关性。方法横断面研究。2017年1月至2018年12月于天津医科大学朱宪彝纪念医院内科住院治疗的T2DM患者707例纳入研究。患者均行双眼散瞳眼底彩色照相。根据DR诊断标准将患者分为DR组、无DR(NDR)组,分别为210、497例;DR组再分为非增生型DR组(NPDR)组、增生型DR(PDR)组,分别为186、24例。检测Hb水平,单因素分析其与DR的相关性;logistic回归分析评价Hb水平与DR风险的关系。结果NDR组、DR组患者Hb分别为(140.58±17.26)、(132.35±23.48)g/dl;与NDR组比较,DR组患者Hb水平显著降低,差异有统计学意义(t=5.107,P=0.000)。NDR组、NPDR组、PDR组,男性患者Hb分别为(149.3±1.01)、(142.6±2.35)、(132.9±8.44)g/dl;女性患者Hb分别为(131.7±0.90)、(124.0±2.09)、(116.8±5.23)g/dl。随DR进展,不同性别者Hb水平均明显减低,差异有统计学意义(P<0.0001)。相关性分析结果显示,Hb降低是DR的独立危险因素(比值比=4.437,95%可信区间2.590~7.603,P<0.0001)。结论T2DM患者Hb降低与DR严重程度呈正相关。Objective To assess the association of hemoglobin(Hb)levels with the prevalence of diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM).Methods A cross-sectional study.From January 2017 to December 2018,707 patients with T2DM who were hospitalized in the Department of Internal Medicine of Chu Hsien-I Memorial Hospital&Tianjin Medical University,were included in the study.All patients underwent color photography of the fundus of both eyes with dilated pupils.According to DR diagnostic criteria,patients were divided into DR group and non-DR(NDR)group,with 210 and 497 cases,respectively;DR group was further divided into non-proliferative DR group(NPDR)group and proliferative DR(PDR)group,about 186,24 cases,respectively.Hb level was detected,single factor analysis of its correlation with DR;logistic regression analysis was used to evaluate the relationship between Hb level and DR risk.Results The Hb levels of the patients in the NDR group and the DR group were 140.58±17.26 and 132.35±23.48 g/dl;compared with the NDR group,the Hb level of the DR group was significantly lower,and the difference was statistically significant(t=5.107,P=0.000).In the NDR group,NPDR group,and PDR group,Hb levels of male patients were 149.3±1.01,142.6±2.35,132.9±8.44 g/dl,respectively;Hb levels of female patients were 131.7±0.90,124.0±2.09,116.8±5.23 g/dl.With the progress of DR,Hb levels of different sexes decreased significantly,and the difference was statistically significant(P<0.0001).The results of correlation analysis showed that Hb reduction was an independent risk factor for DR(odds ratio=4.437,95%confidence interval 2.590-7.603,P<0.0001).Conclusion The reduction of Hb in T2DM patients is positively correlated with the severity of DR.

关 键 词：糖尿病视网膜病变 血红蛋白类 糖尿病 2型 

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