2型糖尿病患者脂肪因子与糖尿病视网膜病变的关联研究  

Associations of adipokine with diabetic retinopathy among patients with type 2 diabetes mellitus

作　　者：孙霞 但玲英 郑鹏 陈薪伊 SUN Xia;DAN lingying;ZHENG Peng;CHEN Xinyi(Lishui TCM Hospital Affiliated to Zhejiang Chinese Medical University,Lishui,Zhejiang 323000,China)

机构地区：[1]浙江中医药大学附属丽水中医院,浙江丽水323000

出　　处：《预防医学》2025年第3期248-252,共5页China Preventive Medicine Journal

基　　金：浙江省医药卫生科技计划项目(2020KY1089,2025KY1994)。

摘　　要：目的探讨2型糖尿病(T2DM)患者网膜素-1、摄食抑制因子-1、艾帕素3种脂肪因子与糖尿病视网膜病变(DR)的关联,为DR防治提供参考。方法选择2021年8月—2023年5月在丽水市中医院住院治疗的T2DM患者为研究对象,根据荧光素眼底血管造影检查结果分为无DR(NDR)组、非增殖型DR(NPDR)组和增殖型DR(PDR)组。通过问卷收集患者性别、年龄和T2DM病程等资料,检测血清网膜素-1、摄食抑制因子-1、艾帕素及有关血生化指标。采用无序多分类logistic回归模型分析网膜素-1、摄食抑制因子-1、艾帕素与DR的关联。结果纳入T2DM患者150例,其中NDR组58例,NPDR组60例,PDR组32例,男性分别占60.34%、45.00%和68.75%;年龄分别为(54.79±14.40)、(57.03±12.20)和(57.72±10.70)岁;T2DM病程M(QR)分别为7.00(7.75)、10.00(8.00)和10.00(5.00)年。与NDR组比较,NPDR组网膜素-1、摄食抑制因子-1水平较低,艾帕素水平较高,PDR组网膜素-1水平较高、艾帕素水平较低;与NPDR组比较,PDR组网膜素-1、摄食抑制因子-1水平较高,艾帕素水平较低(均P<0.05)。无序多分类logistic回归分析结果显示,网膜素-1水平与NPDR(OR=0.503,95%CI:0.291~0.871)、PDR(OR=7.862,95%CI:2.956~20.910)存在统计学关联;摄食抑制因子-1(OR=0.971,95%CI:0.953~0.989)、艾帕素(OR=3.266,95%CI:1.817~5.868)水平与NPDR存在统计学关联。结论T2DM患者血清网膜素-1、摄食抑制因子-1、艾帕素水平与DR不同分期相关。Objective To examine the associations between three adipokines(omentin-1,nesfatin-1 and apelin)and diabetic retinopathy(DR)among patients with type 2 diabetes mellitus(T2DM),so as to provide the basis for the prevention and control of DR.Methods The T2DM patients hospitalized in Lishui TCM Hospital from August 2021 to May 2023 were selected and divided into three groups:no diabetic retinopathy(NDR)group,non-proliferative diabetic retinopathy(NPDR)group,and proliferative diabetic retinopathy(PDR)group based on fundus fluorescein angiography.Data on gender,age,and course of T2DM were collected through questionnaires,and serum omentin-1,nesfatin-1,apelin,and related blood biochemical indicators were measured.The associations of omentin-1,nesfatin-1 and apelin with DR were analyzed using a multinomial logistic regression model.Results A total of 150 T2DM patients were enrolled,including 58 cases in the NDR group,60 cases in the NPDR group,and 32 cases in the PDR group,with males accounting for 60.34%,45.00% and 68.75%,respectively.The mean ages were(54.79±14.40),(57.03±12.20)and(57.72±10.70)years,respectively.The median(interquartile range)courses of T2DM were 7.00(7.75),10.00(8.00)and 10.00(5.00)years,respectively.Compared with the NDR group,the NPDR group had lower levels of omentin-1 and nesfatin-1 and higher level of apelin,while the PDR group had higher level of omentin-1 and lower level of apelin(all P<0.05).Compared with the NPDR group,the PDR group had higher levels of omentin-1 and nesfatin-1 and lower level of apelin(all P<0.05).Multinomial logistic regression analysis showed that omentin-1 level was statistically associated with NPDR(OR=0.503,95%CI:0.291-0.871)and PDR(OR=7.862,95%CI:2.956-20.910);nesfatin-1(OR=0.971,95%CI:0.953-0.989)and apelin(OR=3.266,95%CI:1.817-5.868)levels were statistically associated with NPDR.Conclusion Serum levels of omentin-1,nesfatin-1 and apelin were associated with different stages of DR among T2DM patients.

关 键 词：糖尿病视网膜病变 2型糖尿病 网膜素-1 摄食抑制因子-1 艾帕素 

分 类 号：R587.1[医药卫生—内分泌]