糖尿病视网膜病变合并亚临床甲减患者血清视黄醇结合蛋白4水平改变及其临床意义  

Changes of Serum Retinol Binding Protein 4 Level in Diabetic Retinopathy Complicated with Subclinical Hypothyroidism and Its Clinical Significance

作　　者：蒋艺兰 唐祝奇[2] 鲍家军 朱蓓[1] Jiang Yi-lan;Tang Zhu-qi;Bao Jia-jun;Zhu Bei(Endocrinology Department,Rugao People's Hospital Jiangsu,Rugao 226500,China;Department of Endocrinology,Affiliated Hospital of Nantong University Jiangsu,Nantong 226000,China)

机构地区：[1]如皋市人民医院内分泌科,如皋226500 [2]南通大学附属医院内分泌科,南通226000

出　　处：《湖南师范大学学报（医学版）》2022年第1期130-133,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探究糖尿病视网膜病变(DR)合并亚临床甲减(SCH)患者血清视黄醇结合蛋白4(RBP4)水平改变及其临床意义。方法:选取单纯2型糖尿病患者(DM组)53例、2型糖尿病视网膜病变患者(DR组)53例、2型糖尿病视网膜病变合并亚临床甲状腺功能减退患者(DR合并SCH组)53例为研究对象,同时选取在我院体检的健康志愿者53例为对照组。比较各组空腹血糖(FPG)、血脂、促甲状腺激素(THS)、同型半胱氨酸(Hcy)、胱抑素C(Cys-c)、血清肌酐(Scr)、RBP4等生化指标。结果:DR+SCH组患者BMI、收缩压、舒张压和DM病程均大于其他3组,DR组患者BMI、收缩压、舒张压和DM病程均大于DM组、对照组,对照组BMI、收缩压、舒张压最低。DR+SCH组患者FPG、TG、TC、LDL-C、THS、Hcy、Cys-C、Scr、RBP4均大于其他3组,DR组患者上述各指标均大于DM组、对照组,对照组上述各指标最低。Pearson相关分析显示,TG、LDL-C、TSH、DM病程、Cys-C和Hcy与RBP4均呈正相关(r=0.491、0.563、0.823、0.712、0.678、0.634)。53例SCH患者中,轻度33例,重度20例。重度SCH患者RBP4、Hcy及Cys-C水平均高于轻度SCH患者;Logistic 回归分析显示,糖尿病病程、TG、SCH、Cys-C 、RBP4、Hcy是DR患者发生SCH 的独立危险因素。结论:DR合并SCH患者血清RBP4水平升高且与SCH病情严重程度有关,RBP4是DR患者发生SCH的独立危险因素。Objective To investigate the changes of serum retinol binding protein 4 level in diabetic retinopathy patients with subclinical hypothyroidism and its clinical significance.Methods 53 patients with simple type 2 diabetes mellitus (DM group),53 patients with type 2 diabetic retinopathy (DR group),53 patients with type 2 diabetic retinopathy complicated with subclinical hypothyroidism (DR combined with SCH group) were selected,and 53 healthy volunteers who underwent physical examination in our hospital were selected as control group.The biochemical indexes of blood sugar,blood lipid,thyroid hormone,Hcy,Cys-C,Scr,RBP4,etc.in each group were compared.Results BMI,systolic blood pressure,diastolic blood pressure and duration of DM in DR + SCH group were higher than those in other three groups.BMI,systolic blood pressure,diastolic blood pressure and course of DR group were higher than those in DM group and control group,while BMI,systolic blood pressure and diastolic blood pressure in control group were the lowest.The levels of FPG,TG,TC,LDL-C,ths,Hcy,Cys-C,SCR and RBP4 in DR + SCH group were higher than those in other three groups,the above indexes in DR group were higher than those in DM group and control group,and the above indexes in control group were the lowest.Pearson correlation analysis showed that serum TG,LDL-C,TSH,DM course,Cys-C and Hcy were positively correlated with RBP4(r=0.491,0.563,0.823,0.712,0.678,0.634).Among 53 patients with SCH,33 patients with mild SCH and 20 patients with severe SCH.The levels of RBP4,Hcy and Cys-C in patients with severe SCH were higher than those in patients with mild SCH,and the differences were significan.Multivariate Logistic Regression Analysis:The results showed that the course of diabetes,TG,SCH,Cys-C,RBP4,Hcy were independent risk factors for SCH in DR patients.Conclusion The level of serum RBP4 in DR patients with SCH increases and is related to the severity of SCH.RBP4 is an independent risk factor for SCH in DR patients.

关 键 词：糖尿病 糖尿病视网膜病变 亚临床甲状腺功能减退 血清视黄醇结合蛋白4 

分 类 号：R392.6[医药卫生—免疫学]