血清总胆红素、尿酸、甘油三酯-葡萄糖指数与血糖控制达标的2型糖尿病发生糖尿病视网膜病变的关系研究  

Study on the Relationship between Serum Total Bilirubin,Uric Acid,Triglyceride-Glucose Index and Diabetic Retinopathy in Type 2 Diabetes Mellitus with Standard Blood Glucose Control

作　　者：方薇[1] 王习哲[1] 赵颖[1] 张磊[1] 刘大川[1] FANG Wei;WANG Xi-zhe;ZHAO Ying;ZHANG Lei;LIU Da-chuan(Department of Ophthalmology,Xuanwu Hospital of Capital Medical University,Beijing,100053,China)

机构地区：[1]首都医科大学宣武医院眼科,北京100053

出　　处：《现代生物医学进展》2024年第13期2445-2449,共5页Progress in Modern Biomedicine

基　　金：首都临床特色应用研究项目(Z171100001017029)。

摘　　要：目的:探讨血清总胆红素(TBIL)、尿酸(UA)、甘油三酯-葡萄糖指数(TyGI)与血糖控制达标2型糖尿病(T2DM)患者发生糖尿病视网膜病变(DR)的关系。方法:选取首都医科大学宣武医院2021年1月~2023年10月收治的血糖控制达标T2DM患者317例,根据是否发生DR及病情程度分为增生型DR(PDR)组(93例)、非PDR组(105例)、眼底正常组(119例)。检测血清TBIL、UA水平并计算TyGI。采用多因素Logistic回归分析血糖控制达标T2DM患者发生DR的因素,受试者工作特征(ROC)曲线分析血清TBIL、UA、TyGI对血糖控制达标T2DM患者发生DR的预测价值。结果:PDR组TBIL低于非PDR组、眼底正常组,UA、TyGI高于非PDR组、眼底正常组(P<0.05);非PDR组TBIL低于眼底正常组,UA、TyGI高于眼底正常组(P<0.05)。多因素Logistic回归分析显示T2DM病程延长、甘油三酯升高、UA升高、TyGI升高为血糖控制达标T2DM患者发生DR的独立危险因素,TBIL升高为独立保护因素(P<0.05)。血清TBIL、UA、TyGI联合预测血糖控制达标T2DM患者发生DR的曲线下面积为0.832,大于血清TBIL、UA、TyGI单独预测的0.709、0.695、0.746。结论:血清TBIL降低和UA、TyGI升高是血糖控制达标的T2DM患者发生DR的独立危险因素,联合血清TBIL、UA、TyGI对血糖控制达标T2DM患者发生DR的预测价值较高。Objective:To investigate the relationship between serum total bilirubin(TBIL),uric acid(UA),triglyceride-glucose index(Ty GI)and diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM)with standard blood glucose control.Methods:317 T2DM patients with standard blood glucose control from Xuanwu Hospital of Capital Medical University from January 2021 to October 2023 were selected,and patients were divided into proliferative DR(PDR)group(93 cases),non-PDR group(105 cases)and normal fundus group(119 cases)according to the occurrence of DR and the severity of the disease.Serum TBIL and UA levels were measured and Ty GI was calculated.The factors of DR in T2DM patients with standard blood glucose control were analyzed by multivariate Logistic regression,the predictive value of serum TBIL,UA and Ty GI for DR in T2DM patients with standard blood glucose control were analyzed by receiver operating characteristic(ROC)curve.Results:TBIL in PDR group was lower than that in non-PDR group and normal fundus group,UA and Ty GI were higher than those in non-PDR group and normal fundus group(P<0.05).TBIL in non-PDR group was lower than that in normal fundus group,and UA and Ty GI were higher than those in normal fundus group(P<0.05).Multivariate Logistic regression analysis showed that prolonged course of T2DM,elevated triglyceride,elevated UA,and elevated Ty GI were independent risk factors for DR in T2DM patients with standard blood glucose control,and elevated TBIL was an independent protective factor(P<0.05).The area under the curve of serum TBIL,UA and Ty GI combined to predict DR in T2DM patients with standard blood glucose control was 0.832,which was greater than 0.709,0.695 and 0.746 predicted by serum TBIL,UA and Ty GI alone.Conclusion:The decrease of serum TBIL and the increase of UA and Ty GI are independent risk factors for DR in T2DM patients with standard blood glucose control,the combination of serum TBIL,UA and Ty GI has a higher predictive value for DR in T2DM patients with standard blood glucose c

关 键 词：2型糖尿病 血糖控制达标 糖尿病视网膜病变 总胆红素 尿酸 甘油三酯-葡萄糖指数 

分 类 号：R587.2[医药卫生—内分泌]