2型糖尿病患者血清类胡萝卜素与视网膜血管管径的相关性研究  

Association study of serumcarotenoids with retinal vessel caliber in type 2 diabetic patients

作　　者：佘重阳 沈志军[2] 李芸云[2] 崔敏 刘宁朴[2] She Chongyang;Shen Zhijun;Li Yunyun;Cui Min;Liu Ningpu(Department of Ophthalmology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing Key Laboratory of Ophthalmology and Visual Science,Beijing 100730,China;Department of Ophthalmology,Beijing Haidian Hospital,Beijing 100080,China)

机构地区：[1]首都医科大学附属北京朝阳医院眼科,北京100020 [2]首都医科大学附属北京同仁医院、北京同仁眼科中心眼科学与视觉科学北京市重点实验室,北京100730 [3]北京市海淀医院眼科,北京100080

出　　处：《眼科》2023年第5期409-415,共7页Ophthalmology in China

摘　　要：目的探讨2型糖尿病患者血清类胡萝卜素水平与视网膜血管管径之间的相关性。设计横断面研究。研究对象北京“德胜社区糖尿病眼病研究”的462例2型糖尿病(T2DM)受试者。方法按照纳入排除标准,排除21例受试者后,纳入189例糖尿病无视网膜病变(DWR)患者和252例轻中度非增生性糖尿病视网膜病变(NPDR)患者。通过问卷调查收集人口学和生活方式特征。所有受试者都进行一般身体和眼科检查。使用高效液相色谱法检测血清类胡萝卜素水平。通过半自动软件测定眼底像上视网膜血管管径,包括视网膜中央小动脉当量(CRAE)、视网膜中央小静脉当量(CRVE)和动静脉比值(AVR)。比较两组间各个变量的差异。通过多元Logistic回归分析血清类胡萝卜素水平与视网膜血管管径之间的相关性。主要指标CRAE、CRVE、AVR、血清类胡萝卜素水平。结果DWR组和轻中度NPDR组CRAE分别为(150.8±16.0)μm和(149.9±14.4)μm(t=0.58,P=0.56);CRVE分别为(220.9±22.2)μm和(230.3±25.1)μm(t=3.97,P<0.001);AVR分别为0.68±0.06和0.65±0.06(t=4.85,P<0.001)。矫正其他危险因素后,DWR组中玉米黄质与CRVE正相关(OR=4.03,95%CI:1.40~19.62,P=0.01);轻中度NPDR组中番茄红素与CRVE正相关(OR=1.01,95%CI:1.0002~1.02,P=0.01)。结论轻中度NPDR患者CRVE较DWR患者显著增宽,AVR显著降低;较高的血清玉米黄质和番茄红素水平与较宽的CRVE相关。(眼科,2023,32:409-415)Objective To observe the association between serum carotenoid level and retinal vessel caliber in type 2 diabetic patients.Design Cross-sectional study.Participants A total of 462 subjects with type 2 diabetes mellitus(T2DM)from the Desheng Diabetic Eye Study were enrolled in this study.Methods 21 subjects were excluded according to the inclusion and exclusion criteria.189 patients with diabetes without retinopathy(DWR)and 252 patients with mild to moderate non proliferative diabetic retinopathy(NPDR)were included.Demographic and lifestyle characteristics were collected through questionnaires.All subjects underwent general physical and ophthalmic examinations.Serum carotenoid levels were detected by high performance liquid chromatography.The calibers of retinal vessels,including central retinal arteriolar equivalent(CRAE),central retinal vein equivalent(CRVE)and arteriovenous ratio(AVR),were measured by semi-automatic software.Variables of the two groups were compared.Multivariate Logistic regression analysis was used to analyze the association of serum carotenoid level with retinal vessel caliber.Main Outcome Measures CRAE,CRVE,AVR,serumcarotenoids level.Results The CRAE was 150.8±16.0μm in DWR group and 149.9±14.4μm in mild and moderate NPDR group(t=0.58,P=0.56).The CRVE was 220.9±22.2μm in DWR group and 230.3±25.1μm in mild and moderate NPDR group(t=3.97,P<0.001).The AVR were 0.68±0.06 in DWR group and 0.65±0.06 in mild and moderate NPDR group(t=4.85,P<0.001).After adjusting for other risk factors,serum zeaxanthin was positively associated with CRVE in DWR group(OR=4.03,95%CI:1.40,19.62,P=0.01),and lycopene was positively associated with CRVE in mild and moderate NPDR group(OR=1.01,95%CI:1.0002,1.02,P=0.01).Conclusions The CRVE of NPDR patients was significantly wider and the AVR was significantly lower than those of DWR subjects.Higher levels of serum zeaxanthin and lycopene were associated with wider CRVE.(Ophthalmol CHN,2023,32:409-415)

关 键 词：2型糖尿病 视网膜血管管径 血清类胡萝卜素 

分 类 号：R774.1[医药卫生—眼科] R587.2[医药卫生—临床医学]