2型糖尿病视网膜病变患者血清瘦素、脂联素水平测定及其意义研究

发布时间：2017-12-31 01:33

本文关键词：2型糖尿病视网膜病变患者血清瘦素、脂联素水平测定及其意义研究　出处：《中国临床医生杂志》2016年02期 　论文类型：期刊论文

【摘要】：目的探讨2型糖尿病视网膜病变患者血清瘦素及脂联素水平的变化,并研究其与疾病严重程度的关系。方法收集在本院住院的2型糖尿病(T2DM)患者135例,将其分为单纯糖尿病无视网膜病变组(DM,n=43)、糖尿病合并非增殖期视网膜病变组(NPDR,n=46)和糖尿病合并增殖期视网膜病变组(PDR,n=46)。另选取同期健康体检者45例作为对照组(NC)。观察患者的体检指标,检测患者空腹血糖(FPG)、糖化血红蛋白(Hb A1C)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),并采用酶联免疫吸附法(ELISA)检测患者血清瘦素、脂联素水平。结果各组性别比例、年龄、TC相比,差异无显著性(P0.05)。收缩压、舒张压、BMI、WHR、FPG、Hb A1C、TG、HDL-C及LDLC相比,差异有显著性(P0.05)。NC组、DM组、NPDR组、PDR组血清瘦素水平分别为(9.5±3.5)μg/ml、(13.3±4.0)μg/ml、(17.7±5.8)μg/ml、(23.2±6.5)μg/ml,血清脂联素水平分别为(6.5±1.9)μg/ml、(5.7±1.5)μg/ml、(4.3±1.2)μg/ml、(3.7±1.0)μg/ml。血清瘦素水平随DR病变程度增加而增加(r=0.56,P0.001),血清脂联素水平随DR病变程度增加而降低(r=-0.63,P0.001),这种相关性在排除其他影响因素之后仍存在(χ2=9.7,P=0.004;χ2=11.5,P=0.003);血清瘦素水平与脂联素水平呈负相关性(r=-0.67,P0.001)。结论血清瘦素和脂联素水平是DR病变的独立危险因素,参与了DR的发生和发展,血清瘦素水平与DR病变程度呈正相关,血清脂联素水平与DR病变程度呈负相关,血清瘦素、脂联素可作为预测评估DM患者视网膜病变损伤程度的指标。
[Abstract]:Objective to investigate the changes of serum leptin and adiponectin levels in patients with type 2 diabetic retinopathy. Methods 135 patients with type 2 diabetes mellitus (T2DM) who were hospitalized in our hospital were divided into two groups. Diabetic patients with non-proliferative retinopathy (NPDRN) and diabetic patients with proliferative retinopathy (PDR). Another 45 healthy persons were selected as control group. The parameters of the physical examination were observed, and the fasting blood glucose (FPG) and HbA1C were detected. Total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C). Serum leptin and adiponectin levels were detected by Elisa. Results there was no significant difference in blood pressure between the two groups. There was significant difference in HDL-C and LDLC between DBP group and DM group. The serum leptin levels in PDR group were 9.5 卤3.5 渭 g / ml and 13.3 卤4.0 渭 g / ml respectively. The serum adiponectin levels were 6.5 卤1.9 渭 g / ml and 5.7 卤1.5 渭 g / ml, respectively. The serum leptin level increased with the increase of Dr lesion severity (P 0.001). The serum adiponectin level decreased with the increase of Dr lesion degree, and the correlation was still found after excluding other influencing factors (蠂 2 + 9.7). P0. 004; 蠂 ~ 2 + 11.5P = 0.003; There was a negative correlation between serum leptin level and adiponectin level. Conclusion Serum leptin and adiponectin levels are independent risk factors for Dr. The level of serum leptin was positively correlated with the pathological degree of Dr, and the level of serum adiponectin was negatively correlated with the degree of Dr lesion. Adiponectin can be used as a predictor of the degree of retinopathy injury in DM patients.
【作者单位】：首都医科大学北京宣武医院;
【分类号】：R587.2;R774.1
【正文快照】： 糖尿病视网膜病变(DR)是糖尿病微血管病变的常见并发症之一,是糖尿病患者失明的主要原因。DR发病机制复杂,目前普遍认为长期、慢性的高血糖引发的炎症反应和氧化应激促使血管内皮功能受损是其发病基础[1,2]。瘦素为肥胖基因的编码产物,是一种由脂肪细胞分泌的脂源性多肽激素,

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