目的 研究糖尿病视网膜病变(DR)患者血清视黄醇结合蛋白4(RBP4)和胱抑素C(Cys-C)水平,及其与DR的关系.方法 选取2015年1月—2016年6月南通大学附属海安县人民医院内分泌科、眼科门诊及住院的2型糖尿病(T2DM)患者150例,根据检查结果,将其分为无DR的患者50例(NDM组),糖尿病伴非增殖型DR患者50例(NPDR组),糖尿病伴增殖型DR患者50例(PDR组).另选取同期本院体检正常者50例作为对照组.检测各组血清空腹血糖(FPG)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及餐后2 h血糖(2 Hpg)、糖化血红蛋白(HbA1c)、RBP4和Cys-C水平.结果 各组FPG、TG、TC、LDL-C、HDL-C、2 Hpg、HbA1c、RBP4、Cys-C水平比较,差异均有统计学意义(P<0.05);其中NPDR组患者FPG、TG、TC、2 Hpg、HbA1c、RBP4、Cys-C水平均高于NDM组,HDL-C水平低于NDM组;PDR组患者FPG、TC、2 Hpg、HbA1c、RBP4、Cys-C水平均高于NPDR组(P<0.05).多因素Logistic回归分析结果显示,糖尿病病程〔OR=3.128,95%CI(1.458,7.641)〕、HbA1c〔OR=6.933,95%CI(1.604,29.962)〕、RBP4〔OR=2.746, 95%CI(1.043,7.230)〕、Cys-C〔OR=3.062,95%CI(1.098,9.389)〕是糖尿病患者发生DR的危险因素(P<0.05).结论 血清RBP4和Cys-C水平升高与DR的发生密切相关.%Objective To detect the serum retinol binding protein 4 (RBP4) and cystatin C (Cys-C) levels in patients with diabetic retinopathy (DR),and examine their correlations with the development of DR.Methods A total of 150 outpatients and inpatients with type 2 diabetes mellitus (T2DM) that were admitted to the Department of Endocrinology and Department of Ophthalmology,the People's Hospital of Haian County Affiliated to Nantong University between January 2015 and June 2016 were enrolled and grouped. Fifty diabetic patients without DR were assigned to the non-DM (NDM) group,50 diabetic patients with nonproliferative DR (NPDR) were assigned to the NPDR group,50 diabetic patients with proliferative DR (PDR) were assigned to the PDR group,and 50 normal healthy individuals served as controls. The serum levels of fasting blood glucose (FPG),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C),2-hour postprandial blood glucose (2 hPG),glycosylated hemoglobin (HbA1c),RBP4,and Cys-C were measured.Results There were significant differences in serum FPG,TG,TC, LDL-C,HDL-C,2 hPG,HbA1c,RBP4,and Cys-C levels among the four groups (P<0.05). Higher levels of FPG,TG,TC,2 hPG,HbA1c,RBP4,and Cys-C,and a lower HDL-C concentrationwere detectedin the NPDR group than in the NDM group;in addition,the serum levels of FPG,TC,2 hPG,HbA1c,RBP4 and Cys-C were higher in the PDR group than in the NPDR group(P<0.05).Multivariate Logistic regression analyses revealed that the course of the disease〔OR=3.128,95%CI (1.458,7.641)〕,HbA1c〔OR=6.933,95%CI (1.604,29.962)〕,RBP4〔OR=2.746,95%CI (1.043,7.230)〕, and Cys-C〔OR=3.062,95%CI (1.098,9.389)〕 were risk factors for developing DR (P<0.05).Conclusion Elevated serum RBP4 and Cys-C levels are strongly associated with the development of DR.
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