玻璃体液中褪黑素水平与糖尿病性视网膜病变的相关性研究  

Study on correlation between melatonin levels in vitreous and diabetic retinopathy

作　　者：郭晓静 王文战[1] Guo Xiaojing;Wang Wenzhan(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2023年第11期801-806,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的研究2型糖尿病患者玻璃体液中褪黑素水平与糖尿病性视网膜病变(DR)的相关性。方法前瞻性队列研究。随机纳入郑州大学第一附属医院2021年11月至2023年7月拟行玻璃体切除手术者84例(84只眼), 其中根据疾病种类不同将糖尿病性视网膜病变43例(43只眼)纳入DR组, 原发性孔源性视网膜脱离(RRD)41例(41只眼)纳入RRD组, 于术中抽取患者玻璃体液0.5~1.0 ml, 应用酶联免疫吸附法(ELISA)检测两组患者玻璃体液中褪黑素水平。收集DR组患者的空腹血糖、糖化血红蛋白、糖尿病性视网膜病变分期及糖尿病病程, 并分析其与玻璃体液褪黑素水平的相关性。采用匹兹堡睡眠质量指数量表(PSQI)分析各组患者的睡眠质量, 并采用Spearman相关分析法分析各组玻璃体液褪黑素水平与睡眠相关指标的相关性。结果 DR组的玻璃体液褪黑素水平增高, 其浓度为(70.60±23.56)pg/ml, 高于RRD组的(42.94±21.63)pg/ml(t=5.60, P<0.001)。DR组患者空腹血糖、糖化血红蛋白、糖尿病性视网膜病变分期及糖尿病病程与玻璃体液内褪黑素水平无明显相关性(r=0.01、-0.07、0.06、0.04, P=0.963、0.705、0.712、0.806)。DR组33例的睡眠质量、睡眠效率、睡眠障碍及PSQI总分与其玻璃体液褪黑素水平呈现负相关(r=-0.62、-0.51、-0.40、-0.50;P<0.001、0.003、0.021、0.003), 而入睡时间、睡眠时间及日间功能障碍与其玻璃体液褪黑素水平无相关性(均P>0.05)。RRD组34例的日间功能障碍与其玻璃体液褪黑素水平具有正相关(r=0.36, P=0.038), 余均无相关性(均P>0.05)。结论糖尿病性视网膜病变患者玻璃体液中褪黑素水平升高与DR的发生或发展具有相关性, 睡眠较差的DR患者玻璃体液内褪黑素水平较低。Objective To study the correlation between melatonin levels in vitreous and diabetic retinopathy(DR)in patients with type II diabetes mellitus.Methods This was a prospective cohort study.A total of 84 eyes of 84 cases scheduled for pars plana vitrectomy in the First Affiliated Hospital of Zhengzhou University from Nov.2021 to Jul.2023 were randomly collected and all cases were divided into 2 groups based on disease types:43 eyes of 41 cases with diabetic retinopathy in the DR group,and 43 eyes of 41 cases with primary rhegmatogenous retinal detachment(RRD)in the RRD group.During the operation,0.5-1.0 ml of the patient’s vitreous was extracted,and the melatonin levels in the vitreous of the patients in both groups were detected by enzyme-linked immunosorbent assay(ELISA),and then the melatonin levels were compared between the two groups.Fasting blood glucose,glycosylated hemoglobin,diabetic retinopathy staging and diabetes course in the DR group were collected,and analyzed for correlation to melatonin level in vitreous.Pittsburgh sleep quality index(PSQI)was used to analyze the sleep quality of patients in each group,and Spearman correlation analysis method was used to analyze the correlation between melatonin level in vitreous and sleep-related indicators in each group.Results Vitreous melatonin levels increased in the DR group,and the concentration was(70.60±23.56)pg/ml,which was higher than that of the RRD group(42.94±21.63)pg/ml(t=5.60,P<0.001).Fasting blood glucose,glycated hemoglobin,diabetic retinopathy staging or diabetes course showed insignificant correcation to melatonin level in vitreous in the DR Group(r=0.01,-0.07,0.06,0.04;P=0.963,0.705,0.712,0.806).Sleep quality,sleep efficiency,sleep disorders or PSQI total score of 33 patients in DR group were negatively correlated with their melatonin levels in vitreous(r=-0.62,-0.51,-0.40,-0.50;P<0.001,0.003,0.021,0.003),while the duration of falling asleep,duration of sleep or daytime dysfunction had no significant correlation to melatonin levels in vitreo

关 键 词：糖尿病视网膜病变 褪黑素 玻璃体 检测 液 眼内 

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