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目的:探讨2型糖尿病患者结缔组织生长因子(CTGF)及25-羟维生素D(25-OH-Vit D)水平与视网膜病变的相关性。方法:选择2型糖尿病患者420例,根据免散瞳眼底摄片结果将其分为无视网膜病变(NDR)组和视网膜病变(DR)组;DR组中轻度和中度非增殖期的患者为DR1组,增殖期和重度非增殖期的患者为DR2组。分析3组各项生理指标、CTGF及25-OH-Vit D水平与视网膜病变之间的相关性。结果:DR组糖尿病的病程显著长于NDR组(P<0.05),糖化血红蛋白(Hb A1c)、糖化血清白蛋白(GA)和CTGF水平显著高于NDR组(P<0.05),但25-OH-Vit D水平显著低于NDR组(P<0.05)。DR1组糖尿病的病程显著短于DR2组(P<0.05),Hb A1c、GA、CTGF和总胆固醇(TC)水平显著低于DR2组(P<0.05),但25-OH-Vit D水平显著高于DR2组(P<0.05)。Spearman相关分析显示病程、Hb A1c、GA、CTGF和低密度脂蛋白胆固醇(LDLC)水平与DR之间呈现正相关(P<0.05),而25-OH-Vit D与DR之间呈现负相关(P<0.05);Logistic回归分析结果显示,影响DR发生和病理程度的独立危险因素分别是病程、Hb A1c、25-OH-Vit和CTGF水平(P<0.05)。结论:糖尿病患者体内25-OH-Vit D水平下降与CTGF水平上升共同影响着DR的出现及其病理过程,检测25-OH-Vit D及CTGF水平有助于对患者DR病程进行预测。
Objective: To investigate the correlation between the levels of connective tissue growth factor (CTGF) and 25-hydroxyvitamin D (25-OH-Vit D) and retinopathy in type 2 diabetic patients. Methods: A total of 420 patients with type 2 diabetes mellitus were selected and divided into non-retinopathy (NDR) group and retinopathy group (DR group) according to the results of non-mydriatic fundus photography. Patients with mild and moderate non-proliferative phase in DR group In the DR1 group, patients in the proliferative and severe non-proliferative phases were DR2. The correlations among various physiological indexes, CTGF, 25-OH-Vit D and retinopathy were analyzed. Results: The course of diabetes mellitus in DR group was significantly longer than that in NDR group (P <0.05). The levels of Hb A1c, GA and CTGF in DR group were significantly higher than those in NDR group (P <0.05) Vit D levels were significantly lower than NDR group (P <0.05). The duration of diabetes mellitus in DR1 group was significantly shorter than that in DR2 group (P <0.05). The levels of Hb A1c, GA, CTGF and total cholesterol (TC) in DR1 group were significantly lower than those in DR2 group In DR2 group (P <0.05). Spearman correlation analysis showed that there was a positive correlation between duration of disease, Hb A1c, GA, CTGF and LDLC levels and DR (P <0.05), while negative correlation between 25-OH-Vit D and DR Logistic regression analysis showed that the independent risk factors influencing the occurrence and pathological grade of DR were the course of disease, Hb A1c, 25-OH-Vit and CTGF (P <0.05). CONCLUSION: The decrease of 25-OH-Vit D and the increase of CTGF in diabetic patients affect the appearance of DR and its pathological process. The detection of 25-OH-Vit D and CTGF may be helpful to predict the DR duration.