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目的:探讨血清高分子量脂联素、总脂联素及两者比值与2型糖尿病性视网膜病变的关系,研究非增殖性糖尿病性视网膜病变发生的危险因素。方法:共374例研究对象纳入本研究,包括88例增殖性糖尿病性视网膜病变患者(PDR)、124例非增殖性糖尿病性视网膜病变患者(NPDR)、78例无视网膜病变的糖尿病患者(DR)和84例健康对照志愿者(对照组)。收集人口学资料、体检及实验室指标,ELISA方法测定血清总脂联素和高分子量脂联素水平。统计学分析方法包括协方差分析和累积logit模型。结果:对照组的总脂联素水平高于其他三组(修正均数:5.717、3.310、3.288、3.822 ug/ml,F=18.792,P<0.01),PDR组的总脂联素水平高于NPDR组(P<0.05)。对照组的高分子量脂联素水平高于其他三组(修正均数:2.490、1.425、1.409、1.633 ug/ml,F=14.025,P<0.01),其他三组的高分子量脂联素水平的差异无统计学意义(P>0.05)。高分子量脂联素与总脂联素的比值在四组间的差异无统计学意义(F=0.650,P>0.05)。服药史、高水平的高密度脂蛋白胆固醇、总脂联素和高分子量脂联素是NPDR的保护性因素,年老、糖尿病病程长、肿瘤坏死因子-α升高是NPDR的独立危险因素。结论:较低浓度的血清总脂联素和高分子量脂联素水平可能参与非增殖性糖尿病性视网膜病变的发生,总脂联素水平可能与糖尿病性视网膜病变的严重程度有关。
Objective: To investigate the relationship between serum high molecular weight adiponectin, total adiponectin and type 2 diabetic retinopathy and to study the risk factors of nonproliferative diabetic retinopathy. METHODS: A total of 374 subjects were enrolled in this study, including 88 PDR patients, 124 nonproliferative diabetic retinopathy patients (NPDR) and 78 nondiabetic diabetic patients (DR) And 84 healthy control volunteers (control group). Demographic data, physical examination and laboratory indexes were collected, and serum total adiponectin and high molecular weight adiponectin levels were measured by ELISA. Statistical analysis methods include covariance analysis and cumulative logit models. Results: The total adiponectin level in the control group was higher than those in the other three groups (corrected mean: 5.717, 3.310, 3.288, 3.822 ug / ml, F = 18.792, NPDR group (P <0.05). The levels of high molecular weight adiponectin in the control group were higher than those in the other three groups (corrected mean: 2.490,1.425,1.409,1.633 ug / ml, F = 14.025, P <0.01) The difference was not statistically significant (P> 0.05). The ratio of high molecular weight adiponectin to total adiponectin was not significantly different among the four groups (F = 0.650, P> 0.05). Drug history, high levels of high-density lipoprotein cholesterol, total adiponectin and high molecular weight adiponectin are protective factors of NPDR. Older age, longer duration of diabetes and elevated tumor necrosis factor-α are independent risk factors for NPDR. Conclusion: The lower serum total adiponectin and high molecular weight adiponectin levels may be involved in the occurrence of non-proliferative diabetic retinopathy, the total adiponectin levels may be related to the severity of diabetic retinopathy.