血清FABP4、STRA6水平和血糖变异度与2型糖尿病并发干眼症相关性研究  

Correlation between serum FABP4,STRA6 levels,glycemic variability and type 2 diabetes mellitus complicated by dry eye disease

作　　者：杨秀丽 刘利丽 彭璟[1] 曾洪波[1] YANG Xiuli;LIU Lili;PENG Jing;ZENG Hongbo(Department of Ophthalmology,Zigong First People’s Hospital,Zigong 643000,China)

机构地区：[1]自贡市第一人民医院眼科,四川自贡643000

出　　处：《陕西医学杂志》2025年第5期649-653,658,共6页Shaanxi Medical Journal

基　　金：四川省卫生健康委员会医学科学研究计划项目(2022HJK661)。

摘　　要：目的:探讨血清脂肪酸结合蛋白4(FABP4)、视黄酸诱导基因6(STRA6)水平和血糖变异度与2型糖尿病(T2DM)并发干眼症(DED)的相关性。方法:选取T2DM并发DED患者108例为实验组,另选取同期单纯T2DM患者108例为对照组。根据DED严重程度将试验组患者分为轻度组(51例)、中度组(30例)和重度组(27例)。比较试验组和对照组患者临床资料及血清FABP4、STRA6水平及血糖变异度。比较不同严重程度T2DM并发DED患者血清FABP4、STRA6水平及血糖变异度。T2DM患者并发DED的影响因素采用二元Logistic回归进行分析。绘制受试者工作特征(ROC)曲线分析血清FABP4、STRA6、血糖变异度对T2DM并发DED的预测价值。结果:与对照组比较,试验组病程更长、血红蛋白(HbA1c)水平更高、泪膜破裂时间(BUT)更短(均P<0.05)。试验组血清FABP4、STRA6水平以及血糖变异度高于对照组(均P<0.05)。重度组血清FABP4、STRA6水平及血糖变异度高于轻度组和中度组,中度组血清FABP4、STRA6水平及血糖变异度高于轻度组(均P<0.05)。病程、HbA1c、BUT、血清FABP4、血清STRA6、血糖变异度是T2DM患者并发DED的影响因素(均P<0.05)。血清FABP4、STRA6、血糖变异度三者联合预测T2DM并发DED的曲线下面积(AUC)大于三者单独预测的AUC(均P<0.05)。结论:T2DM并发DED患者血清FABP4、STRA6水平及血糖变异度升高,与DED严重程度有关,三者联合对T2DM并发DED具有较高的预测价值。Objective:To investigate the correlation between serum fatty acid binding protein 4(FABP4),stimulated by retinoic acid 6(STRA6)levels,glycemic variability and type 2 diabetes mellitus(T2DM)complicated by dry eye disease(DED).Methods:A total of 108 T2DM patients with DED were selected as the experimental group,and 108 patients with T2DM alone during the same period were selected as the control group.The experimental group was further divided into mild(51 cases),moderate(30 cases)and severe(27 cases)subgroups based on DED severity.Clinical data,serum FABP4,STRA6 levels,and glycemic variability were compared between the experimental and control groups.Serum FABP4,STRA6 levels and glycemic variability were also compared across DED severity subgroups.Binary logistic regression analysis was used to identify influencing factors for DED in T2DM patients.Receiver operating characteristic(ROC)curves were plotted to analyze the predictive value of serum FABP4,STRA6 and glycemic variability for DED in T2DM patients.Results:Compared with the control group,the experimental group had a longer disease course,higher HbA1c levels,and shorter BUT(all P<0.05).Serum FABP4,STRA6 levels and glycemic variability were higher in the experimental group than in the control group(all P<0.05).The severe subgroup exhibited higher serum FABP4,STRA6 levels and glycemic variability compared to the mild and moderate subgroups,while the moderate subgroup showed higher levels than the mild subgroup(all P<0.05).Disease duration,HbA1c,BUT,serum FABP4,serum STRA6 and glycemic variability were identified as influencing factors for DED in T2DM patients(all P<0.05).The combined AUC for serum FABP4,STRA6 and glycemic variability in predicting T2DM combined with DED was greater than the AUCs of individual predictors(all P<0.05).Conclusion:Elevated serum FABP4,STRA6 levels and glycemic variability are associated with the severity of DED in T2DM patients.The combination of these three parameters shows high predictive value for DED in T2DM.

关 键 词：2型糖尿病 干眼症 脂肪酸结合蛋白4 视黄酸诱导基因6 血糖变异度 相关性 

分 类 号：R587.1[医药卫生—内分泌]