血浆致动脉硬化指数与糖尿病视网膜病变的相关性研究

Correlation between atherogenic index of plasma and diabetic retinopathy

  • 摘要:
    目的 探讨血浆致动脉硬化指数(AIP)与糖尿病视网膜病变(DR)的相关性。
    方法 选取在徐州医科大学附属医院内分泌科住院的2型糖尿病患者445例为研究对象,根据DR诊断及分期标准将患者分为无DR(NDR)组188例、非增生型DR(NPDR)组134例、增生型DR(PDR)组123例。比较各组患者一般资料和主要生化指标,计算AIP。采用Logistic回归分析探讨发生DR的危险因素,采用Spearman相关性分析探讨AIP与各危险因素的相关性,采用受试者工作特征(ROC)曲线分析AIP筛查DR的价值。
    结果 PDR组的年龄大于NDR组和NPDR组,病程长于NDR组和NPDR组,空腹血糖(FBG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)及AIP高于NDR组和NPDR组,估算肾小球滤过率(eGFR)水平低于NDR组和NPDR组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄、病程、HbA1c、LDL-C、eGFR及AIP是T2DM患者发生DR的独立影响因素。T2DM患者AIP预测发生DR时的曲线下面积为0.745(95%CI为0.700~0.791)。应用AIP筛查DR的阈值为0.186, 灵敏度为74.3%, 特异度为64.4%。
    结论 AIP可能是T2DM患者DR筛查可靠的新指标。

     

    Abstract:
    Objective To explore the correlation between atherogenic index of plasma(AIP) and diabetic retinopathy(DR).
    Methods A total of 445 patients with type 2 diabetes hospitalized in the Affiliated Hospital of Xuzhou Medical University were selected as study objects. According to DR diagnosis and staging criteria, the patients were divided into non-DR group (NDR group, n=188), nonproliferative group (NPDR group, n=134) and proliferative group (PDR group, n=123). The general information of patients and main biochemical indicators were collected. The general data and main biochemical indicators of patients in each group were compared, and AIP was calculated. The risk factors of DR were analyzed by Logistic regression, the correlations of AIP with risk factors were analyzed by Spearman correlation, and receiver operating characteristic (ROC) curve was used to analyze the value of AIP in screening DR.
    Results Age in the PDR group was older, duration of diabetes in the PDR group was longer, the level of fasting blood glucose(FBG), glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), triglyceride (TG) and AIP in the PDR group were significantly higher, and the level of estimated glomerular filtration (eGFR) were lower than those in the NDR group and NPDR group(P < 0.05). Logistic regression analysis showed that age, duration of diabetes, HbA1c, LDL-C, eGFR and AIP were independent influencing factors for DR in T2DM patients. The area under the curve of AIP in predicting DR in T2DM patients was 0.745 (95%CI, 0.700 to 0.791). The threshold of AIP for DR screening was 0.186, the sensitivity was 74.3%, and the specificity was 64.4%.
    Conclusion AIP may be a reliable new indicator for DR screening in T2DM patients.

     

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