| 范瑞磊,魏若愚,金培新,等.尿微量白蛋白 /肌酐比值、趋化因子样受体 1、血清 25-羟胆骨化醇与糖尿病视网膜病变的关系[J].安徽医药,2022,26(10):2081-2085. |
| 尿微量白蛋白 /肌酐比值、趋化因子样受体 1、血清 25-羟胆骨化醇与糖尿病视网膜病变的关系 |
| Relationship between urine microalbumin/creatinine ratio, chemokine-like receptor 1, 25-hydroxycholecalciferol and diabetic retinopathy |
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| DOI：10.3969/j.issn.1009-6469.2022.10.040 |
| 中文关键词: 糖尿病视网膜病变 病人病情 尿微量白蛋白 /肌酐比值 趋化因子样受体 1 血清 25-羟胆骨化醇 |
| 英文关键词: Diabetic retinopathy Patient acuity Urine microalbumin/creatinine ratio Chemokine-like receptor 1 Serum 25-hydroxycholecalciferol |
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| 中文摘要: |
| 目的探讨尿微量白蛋白 /肌酐比值( UACR)、趋化因子样受体 1(CMKLR1)、血清 25-羟胆骨化醇［ 25(OH)VD］与糖尿病视网膜病变( DR)发生及病变程度的关系。方法选择 2019年 5月至 2020年 1月邢台市第五医院 160例 2型糖尿病( T2DM)伴 DR病人、 80例无 DR的 T2DM病人及 50例健康体检人群作为研究对象，其中 DR病人根据病变程度分为非增生期 98例与增生期 62例。所有研究对象均采用 ELISA法(酶联免疫吸附法)检测 CMKLR1、25(OH)VD水平，采用免疫比浊法及肌酐酶法计算 UACR值，分析其与 DR发生及病变程度的相关性；并采用 ROC曲线分析其价值。结果三组 T2DM病人病程比较差异有统计学意义( P<0.05)Spearman相关系数为 3.97(P<0.001)。四组研究对象空腹血糖( FPG)、糖化血红蛋白( HbA1c)、三酰甘油(TG)、低密度脂蛋白(，LDL-C)、 UACR、CMKLR1及 25(OH)VD比较差异有统计学意义( P<0.05)。两两比较:增生期组 FPG(7.65±1.87)mmol/L、HbA1c(9.86±1.43)%、TG(2.41±0.32)mmol/L、LDL-C(3.42±0.51)mmol/L、UACR(345.55±40.65)mg/g及 CMKLR1(69.63±6.54)μg/L均高于对照组( 4.31±1.19)mmol/L、(4.53±0.95)%、(1.59±0.53)mmol/L、(1.73±0.61)mmol/L、(9.33± 3.38)mg/g、(69.63±6.54)μg/L及 T2DM非 DR组( 6.26±1.85)mmol/L、(6.47±1.66)%、(1.79±0.47)mmol/L、(2.44±0.66)mmol/L、(25.96±6.73)mg/g、(44.11±6.51)μg/L(P<0.05)， HbA1c、UACR及 CMKLR1均高于非增生期组( P<0.05)而 25(OH)VD低于对照组、 T2DM非 DR组及非增生期组( P<0.05)；非增生期组 FPG、HbA1c、TG、LDL-C、UACR及 CMKLR1均高，于对照组( P<0.05)FPG、HbA1c、TG、LDL-C、UACR高于 T2DM非 DR组( P<0.05)而 25(OH)VD低于对照组( P<0.05)； T2DM非 DR组 FPG、HbA1c、，LDL-C、UACR、CMKLR1均高于对照组( P<0.05)25(OH)VD低于，对照组( P<0.05)。logistic回归分析:病程长、 HbA1c高、 UACR高、 CMKLR1高及 25(OH)VD低是 DR发生的危险，因素( P<0.05)；病程长、 UACR高、 CMKLR1高及 25(OH)VD低是增生期 DR发生的危险因素( P<0.05)。 UACR、CMKLR1及 25(OH)VD预测 DR的 AUC面积分别为 0.77、0.70、0.76；病程、 UACR、CMKLR1及 25(OH)VD预测增生期 DR的 AUC面积分别为 0.77、0.72、0.73、0.74。结论糖尿病病程、 UACR、CMKLR1、25(OH)VD与 DR发生及病变程度密切相关，且对 DR发生及病变程度具有较好的预测价值。 |
| 英文摘要: |
| Objective To explore the relationship between the occurrence and severity of diabetic retinopathy (DR) and urine micro.albumin/creatinine ratio (UACR), chemokine-like receptor 1 (CMKLR1), serum 25-hydroxycholecalciferol [25(OH)VD].Methods A total of 160 patients with type 2 diabetes mellitus (T2DM) accompanied by DR, 80 patients with T2DM without DR and 50 healthy con.trol subjects in The Fifth Hospital of Xingtai from May 2019 to January 2020 were selected as the research subjects, among whom DRpatients were further divided into non-proliferative phase group (n=98) and proliferative phase group (n=62) according to the degree of lesion. For all the subjects ELISA method (enzyme-linked immunosorbent assay) was used to detect CMKLR1, 25 (OH) VD levels, im.munoturbidimetry and creatinase method to calculate the UACR value, and their correlation with DR occurrence and pathological ex.tent was analyzed, and ROC curve was used to analyze its value.Results There was a significant difference in the course of disease among the three groups of T2DM patients (P<0.05), and the Spearman correlation coefficient was 3.97 (P<0.001). Differences in fastingblood glucose (FPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), low density lipoprotein (LDL-C), UACR, CMKLR1 and 25 (OH)VD among the four groups were statistically significant (P<0.05). Pairwise comparison showed: in the proliferative phase group,FPG (7.65±1.87) mmol/L, HbA1c (9.86±1.43) %, TG (2.41±0.32) mmol/L, LDL-C (3.42±0.51) mmol/L, UACR (345.55±40.65) mg/gand CmKLR1 (69.63±6.54) μg/L were higher than those in the control group [(4.31±1.19) mmol/L, (4.53±0.95) %, (1.59±0.53) mmol/L,(1.73±0.61) mmol/L, (9.33±3.38) mg/g, (69.63±6.54) μ g/L] and non-DR group [(6.26±1.85) mmol/L, (6.47±1.66) %, (1.79±0.47) mmol/ L, (2.44±0.66) mmol/L, (25.96±6.73) mg/g, (44.11±6.51) μg/L] (P<0.05). HbA1c, UACR and CMKLR1 were higher than those in the non-proliferative phase group (P<0.05), while the 25 (OH) VD was lower than that in the control group, the T2DM non-DR group and the non-proliferative phase group. In the non-proliferative phase group, FPG, HbA1c, TG, LDL-C, UACR and CMKLR1 were higher than those in the control group (P<0.05). FPG, HbA1c, TG, LDL-C and UACR were higher than those in the T2DM non-DR group (P< 0.05), while 25(OH)VD was lower than that in the control group (P<0.05). In the non-DR group of T2DM, the levels of FPG, HbA1c, LDL-C, UACR and CMKLR1 were higher than those of the control group (P<0.05), and the level of 25(OH)VD was lower than that of the control group (P<0.05). Logistic regression analysis results showed that long course of disease, high HbA1c, high UACR, highCMKLR1 and low 25(OH)VD were the risk factors for DR (P<0.05). The long course of disease, high UACR, high CMKLR1 and low 25(OH)VD were the risk factors for DR in the proliferative phase (P<0.05). AUC areas of UACR, CMKLR1, and 25(OH)VD for the predic.tion of DR were 0.77, 0.70, and 0.76, respectively. The AUC areas of course of disease, UACR, CMKLR1 and 25(OH)VD for the predic.tion of DR in proliferative phase were 0.77, 0.72, 0.73 and 0.74, respectively.Conclusion The course of diabetes, UACR, CMKLR1and 25(OH)VD are closely related to the occurrence and severity of DR, which have a good predictive value for the occurrence and se.verity of DR. |
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