2型糖尿病合并白内障患者血清HbA1c、25(OH)D、MMP-9与术后并发干眼的关系分析  

Analysis of the Relationship between Serum HbA1c,25(OH)D,MMP-9 and Postoperative Dry Eye in Patients with Type 2 Diabetes Mellitus Complicated with Cataract

作　　者：梁明明 倪焰[1] 杨超[1] 丁瑜芝 冯冰 LIANG Ming-ming;NI Yan;YANG Chao;DING Yu-zhi;FENG Bing(Department of Ophthalmology,Zhongda Hospital Affiliated to Southeast University,Nanjing,Jiangsu,210003,China)

机构地区：[1]东南大学附属中大医院眼科,江苏南京210003

出　　处：《现代生物医学进展》2024年第17期3359-3364,共6页Progress in Modern Biomedicine

基　　金：江苏省自然科学基金项目(BK20205870)。

摘　　要：目的:探讨2型糖尿病(T2DM)合并白内障患者血清糖化血红蛋白(HbA_(1c))、25羟维生素D[25(OH)D]、基质金属蛋白酶-9(MMP-9)与术后并发干眼的关系。方法:选取2019年1月~2023年12月在我院行超声乳化白内障吸除术联合人工晶体植入术治疗的T2DM合并白内障患者162例,根据术后是否发生干眼分为干眼组(53例)和非干眼组(109例),检测血清HbA_(1c)、25(OH)D、MMP-9水平。采用多因素Logistic回归分析T2DM合并白内障手术患者术后并发干眼的因素,受试者工作特征(ROC)曲线分析血清HbA_(1c)、25(OH)D、MMP-9水平对T2DM合并白内障患者术后并发干眼的预测价值。结果:与非干眼组比较,干眼组血清HbA_(1c)、MMP-9水平升高,25(OH)D水平降低(P<0.05)。多因素Logistic回归分析显示,T2DM病程延长(OR=1.245,95%CI:1.007~1.539)、HbA_(1c)升高(OR=3.132,95%CI:1.745~5.624)、MMP-9升高(OR=1.206,95%CI:1.091~1.333)为T2DM合并白内障手术患者术后并发干眼的独立危险因素,25(OH)D升高(OR=0.854,95%CI:0.773~0.945)为独立保护因素(P<0.05)。ROC曲线分析显示,血清HbA_(1c)、25(OH)D、MMP-9水平联合预测T2DM合并白内障患者术后并发干眼的曲线下面积为0.921(95%CI:0.868~0.957),大于血清HbA_(1c)、25(OH)D、MMP-9水平单独预测的0.793(95%CI:0.723~0.853)、0.779(95%CI:0.707~0.840)、0.783(95%CI:0.711~0.844)。结论:T2DM合并白内障患者术前血清HbA_(1c)、MMP-9水平升高和25(OH)D水平降低与术后并发干眼密切相关,血清HbA_(1c)、25(OH)D、MMP-9联合预测T2DM合并白内障手术患者术后并发干眼的价值较高。Objective:To investigate the relationship between serum hemoglobin A1c(HbA_(1c)),25 hydroxyvitamin D[25(OH)D],matrix metalloproteinase-9(MMP-9)and postoperative dry eye in patients with type 2 diabetes mellitus(T2DM)complicated with cataract.Methods:162 patients with T2DM complicated with cataract who underwent phacoemulsification combined with intraocular lens implantation in our hospital from January 2019 to December 2023 were selected,patients were divided into dry eye group(53 cases)and non-dry eye group(109 cases)according to whether dry eye occurred after surgery.The levels of serum HbA_(1c),25(OH)D and MMP-9 were detected.The factors of postoperative dry eye in patients with T2DM complicated with cataract surgery were analyzed by multivariate Logistic regression,the predictive value of serum HbA_(1c),25(OH)D and MMP-9 levels for postoperative dry eye in patients with T2DM complicated with cataract were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with non-dry eye group,the levels of serum HbA_(1c) and MMP-9 in dry eye group increased,and the level of 25(OH)D decreased(P<0.05).Multivariate Logistic regression analysis showed that prolonged course of T2DM(OR=1.245,95%CI:1.007~1.539),elevated HbA_(1c)(OR=3.132,95%CI:1.745~5.624),and elevated MMP-9(OR=1.206,95%CI:1.091~1.333)were independent risk factors for postoperative dry eye in patients with T2DM complicated with cataract surgery,Elevated 25(OH)D(OR=0.854,95%CI:0.773~0.945)was an independent protective factor(P<0.05).ROC curve analysis showed that,the area under the curve of combined prediction of serum HbA_(1c),25(OH)D and MMP-9 levels for postoperative dry eye in T2DM patients with cataract was 0.921(95%CI:0.868~0.957),which was greater than 0.793(95%CI:0.723~0.853),0.779(95%CI:0.707~0.840)and 0.783(95%CI:0.711~0.844)predicted by serum HbA_(1c),25(OH)D and MMP-9 levels alone.Conclusion:Elevated preoperative serum HbA_(1c) and MMP-9 levels and the decrease of 25(OH)D levels in patients with T2DM complicated with cataract are c

关 键 词：2型糖尿病 白内障 干眼 糖化血红蛋白 25羟维生素D 基质金属蛋白酶-9 

分 类 号：R587.2[医药卫生—内分泌] R776.1[医药卫生—内科学]