25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性：单中心回顾性研究

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性：单中心回顾性研究

王霖霞, 苏娜, 郭宁宁, 白国欣, 张云娜, 赵晓鹏, 纪桂梅, 高芳, 王光亚, 许金秀, 高瑞新

文章导航 > 协和医学杂志 > 2019 > 10(2): 143-147

王霖霞, 苏娜, 郭宁宁, 白国欣, 张云娜, 赵晓鹏, 纪桂梅, 高芳, 王光亚, 许金秀, 高瑞新. 25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性：单中心回顾性研究[J]. 协和医学杂志, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

引用本文:

王霖霞, 苏娜, 郭宁宁, 白国欣, 张云娜, 赵晓鹏, 纪桂梅, 高芳, 王光亚, 许金秀, 高瑞新. 25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性：单中心回顾性研究[J]. 协和医学杂志, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

Lin-xia WANG, Na SU, Ning-ning GUO, Guo-xin BAI, Yun-na ZHANG, Xiao-peng ZHAO, Gui-mei JI, Fang GAO, Guang-ya WANG, Jin-xiu XU, Rui-xin GAO. Correlation of 25-hydroxy Vitamin D and Lipoprotein-associated Phospholipase A2 with Diabetic Retinopathy: A Single-center Retrospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

Citation:

Lin-xia WANG, Na SU, Ning-ning GUO, Guo-xin BAI, Yun-na ZHANG, Xiao-peng ZHAO, Gui-mei JI, Fang GAO, Guang-ya WANG, Jin-xiu XU, Rui-xin GAO. Correlation of 25-hydroxy Vitamin D and Lipoprotein-associated Phospholipase A2 with Diabetic Retinopathy: A Single-center Retrospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

王霖霞, 苏娜, 郭宁宁, 白国欣, 张云娜, 赵晓鹏, 纪桂梅, 高芳, 王光亚, 许金秀, 高瑞新. 25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性：单中心回顾性研究[J]. 协和医学杂志, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

引用本文:

王霖霞, 苏娜, 郭宁宁, 白国欣, 张云娜, 赵晓鹏, 纪桂梅, 高芳, 王光亚, 许金秀, 高瑞新. 25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性：单中心回顾性研究[J]. 协和医学杂志, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

Lin-xia WANG, Na SU, Ning-ning GUO, Guo-xin BAI, Yun-na ZHANG, Xiao-peng ZHAO, Gui-mei JI, Fang GAO, Guang-ya WANG, Jin-xiu XU, Rui-xin GAO. Correlation of 25-hydroxy Vitamin D and Lipoprotein-associated Phospholipase A2 with Diabetic Retinopathy: A Single-center Retrospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

Citation:

Lin-xia WANG, Na SU, Ning-ning GUO, Guo-xin BAI, Yun-na ZHANG, Xiao-peng ZHAO, Gui-mei JI, Fang GAO, Guang-ya WANG, Jin-xiu XU, Rui-xin GAO. Correlation of 25-hydroxy Vitamin D and Lipoprotein-associated Phospholipase A2 with Diabetic Retinopathy: A Single-center Retrospective Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(2): 143-147. doi: 10.3969/j.issn.1674-9081.2019.02.011

25-羟维生素D、脂蛋白相关磷脂酶A2与糖尿病视网膜病变的相关性：单中心回顾性研究

doi: 10.3969/j.issn.1674-9081.2019.02.011

1.
沧州市中心医院内分泌二科，河北沧州 061000
2.
沧州市中心医院党委办公室，河北沧州 061000
3.
沧州市中心医院眼一科，河北沧州 061000

基金项目:

2016年沧州市市级指导计划 162302047

通讯作者:
王霖霞电话：0317-2075935，E-mail：wanglinxia82@163.com

中图分类号: R58
计量
- 文章访问数: 546
- HTML全文浏览量: 55
- PDF下载量: 405
- 被引次数: 0
出版历程
- 收稿日期: 2017-11-08
- 刊出日期: 2020-09-18

Correlation of 25-hydroxy Vitamin D and Lipoprotein-associated Phospholipase A2 with Diabetic Retinopathy: A Single-center Retrospective Study

1.
The Second Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei 061000, China
2.
Party Committee Office, Cangzhou Central Hospital, Cangzhou, Hebei 061000, China
3.
The First Department of Ophthalmology, Cangzhou Central Hospital, Cangzhou, Hebei 061000, China

More Information

Corresponding author: WANG Lin-xia Tel：0317-2075935，E-mail：wanglinxia82@163.com

摘要: 目的探讨25-羟维生素D[25-hydroxy vitamin D, 25(OH)D]、脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2, LP-PLA2)与糖尿病视网膜病变(diabetic retinopathy, DR)的相关性。方法回顾性收集并分析2014年5月至2017年1月沧州市中心医院内分泌科收治的2型糖尿病患者的临床资料，根据眼底摄片结果，分为糖尿病不伴视网膜病变组(no DR, NDR)组，背景期糖尿病伴视网膜病变(background DR, BDR)组和增殖期糖尿病伴视网膜病变(proliferative DR, PDR)组，选取同期于本院进行体检的健康人作为对照组。比较4组相关生化指标水平，采用Pearson相关分析及多元Logistic回归分析DR的相关及独立危险因素。结果共340例符合纳入和排除标准的2型糖尿病患者入选本研究，其中NDR组125例、BDR组118例、PDR组97例, 对照组100例。4组间的性别、年龄、体质量指数、收缩压、舒张压、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、空腹血糖差异无统计学意义(P均＞0.05)；NDR组、BDR组、PDR组的病程逐渐增长(P=0.003)，NDR组、BDR组、PDR组糖化血红蛋白A1C(glycated hemoglobin A1c, HbA1c)、糖化白蛋白(glycated albumin, GA)、血清胱抑素C(serum cystatin C, Cys-C)、LP-PLA2均显著高于健康对照组, 25(OH)D显著低于健康对照组(P均＜0.05)；NDR、BDR、PDR组间两两比较，HbA1c、GA、Cys-C、LP-PLA2、25(OH)D差异亦有统计学意义(P均＜0.05)。Pearson相关分析显示，病程、HbA1c、GA、Cys-C及LP-PLA2与DR呈正相关(P均=0.000)，25(OH)D与DR呈负相关(P=0.000)。多元Logistic回归分析显示，病程、HbA1c、Cys-C、LP-PLA2、25(OH)D与DR及其严重程度均独立相关(P均＜0.05)。结论 25(OH)D 、LP-PLA2水平与DR的发生、发展密切相关，25(OH)D是其保护因素，而LP-PLA2是其危险因素。
- 25-羟维生素D /
- 脂蛋白相关磷脂酶A2 /
- 糖尿病视网膜病变
Abstract: Objective To investigate the correlation of 25-hydroxy vitamin D [25-(OH)D] and lipopro- tein-associated phospholipase A2(LP-PLA2) with diabetic retinopathy(DR). Methods From May 2014 to January 2017, data of patients with type 2 diabetes mellitus from the Department of Endocrinology of Cangzhou Central Hospital were retrospectively analyzed and selected for the study. Patients were divided into three groups according to the Results of fundus photography:type 2 diabetes mellitus without retinopathy (NDR group), background type 2 diabetic retinopathy(BDR group), and proliferative stage 2 diabetic retinopathy (PDR group), and healthy subjects who took a medical examination were selected as the control group. Relative biochemical indexes were compared among the four groups.Pearson correlation analysis and multiple Logistic regression were carried out to analyze the correlated and independent risk factors. Results Three hundred and forty type 2 diabetic patients (NDR group:125 cases, BDR group: 118 cases, PDR group: 97 cases) and 100 healthy controls were selected for this study. There was no significant difference in sex, age, body mass index, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and fasting blood glucose among the four groups (all P > 0.05). The course of the NDR group was shorter than that of the BDR group, and the later was shorter than that of the PDR group (P < 0.05). Compared with the control group, glycated hemoglobin A1c(HbA1c), glycated albumin (GA), serum cystatin C (Cys-C), and LP-PLA2 were significantly higher, and 25(OH)D was significantly lower in NDR group, BDR group, and PDR group(all P < 0.05). Among the BDR group, PDR group, and NDR group, HbA1c, GA, Cys-C, LP-PLA2, and 25(OH)D also had significant differences (all P < 0.05). After Pearson correlation analysis, the course of the disease, HbA1c, GA, Cys-C, and LP-PLA2 were positively correlated with DR (all P=0.000), and 25(OH)D had a negative correlation with DR(P=0.000). After Logistic regression analysis, the course of the disease, HbA1c, Cys-C, and LP-PLA2 were independent risk factors of DR, and 25(OH)D was the protective factor of DR(all P < 0.05). Conclusions 25(OH)D and LP-PLA2 levels are closely related to the occurrence and development of DR. 25(OH)D is the protective factor, and LP-PLA2 is a risk factor.
- 25-hydroxy vitamin D /
- lipoprotein-associated phospholipase A2 /
- diabetic retinopathy
注释:

利益冲突 无

表 1 2型糖尿病视网膜病变患者与健康对照组一般临床资料比较

指标	2型糖尿病视网膜病变患者			健康对照组(n=100)	F值	P值
指标	NDR组(n=125)	BDR组(n=118)	PDR组(n=97)	健康对照组(n=100)	F值	P值
性别(男/女, n)	64/61	61/57	50/47	52/48	-	-
年龄(x±s，岁)	56.8±5.4	57.3±6.2	57.8±5.8	58.1±6.5	1.564	0.353
病程(x±s，年)	2.9±1.1	7.1±1.7	9.2±2.4	-	16.112	0.003
BMI(x±s，kg/m²)	25.1±2.4	24.6±1.9	25.5±2.1	24.3±1.8	1.587	0.265
收缩压(x±s，mm Hg)	129.7±10.5	134.2±11.5	136.5±12.4	112.4±9.5	1.064	0.564
舒张压(x±s，mm Hg)	82.5±8.1	81.4±8.6	80.8±7.9	66.9±5.8	1.065	0.561
NDR：糖尿病不伴视网膜病变；BDR：背景期糖尿病伴视网膜病变；PDR：增殖期糖尿病伴视网膜病变；BMI：体质量指数

下载: 导出CSV

表 2 2型糖尿病视网膜病变患者与健康对照组血清学指标比较(x±s)

指标	2型糖尿病视网膜病变患者			健康对照组(n=100)	F值	P值
指标	NDR组(n=125)	BDR组(n=118)	PDR组(n=97)	健康对照组(n=100)	F值	P值
TC(mmol/L)	4.92±1.03	4.99±1.08	5.13±1.14	3.86±0.45	1.045	0.620
TG(mmol/L)	1.81±0.76	1.75±0.72	1.88±0.84	1.13±0.15	1.024	0.625
LDL-C(mmol/L)	2.53±1.02	2.65±1.01	2.58±1.04	2.16±0.83	1.031	0.624
HDL-C(mmol/L)	1.46±0.65	1.38±0.57	1.33±0.61	1.75±0.79	1.611	0.264
FPG(mmol/L)	7.69±1.57	8.25±1.84	8.81±1.92	4.91±1.35	1.455	0.356
HbA1c(%)	7.2±1.8^*#	8.6±2.1^*#	10.4±2.5^*#	5.3±1.4	3.325	0.027
GA(%)	21.46±3.27^*#	22.51±3.72^*#	23.77±4.12^*#	16.74±2.15	6.711	0.012
Cys-C(mg/L)	0.94±0.13^*#	1.15±0.14^*#	1.35±0.19^*#	0.62±0.12	4.529	0.025
LP-PLA2(μg/L)	135.68±28.53^*#	151.73±31.66^*#	173.59±34.16^*#	71.46±14.72	6.283	0.016
25(OH)D(nmol/L)	45.3±5.8^*#	31.5±5.1^*#	20.4±4.6^*#	60.5±7.9	3.161	0.036
NDR、BDR、PDR：同表 1；TC：总胆固醇；TG：甘油三酯；LDL-C：低密度脂蛋白胆固醇；HDL-C：高密度脂蛋白胆固醇；FPG：空腹血糖；HbA1c：糖化血红蛋白A1c；GA：糖化白蛋白；Cys-C：血清胱抑素C；LP-PLA2：脂蛋白相关磷脂酶A2；25(OH)D：25-羟维生素D；^*与健康对照组相比，P均＜0.05；^#NDR、BDR、PDR组间两两比较，P均＜0.05

下载: 导出CSV

表 3 糖尿病视网膜病变的危险因素分析

危险因素	β值	SE值	Wald值	P值	OR值	95%CI
病程	1.713	0.562	9.514	0.000	6.093	1.763~18.253
HbA1c	1.802	0.571	9.565	0.000	6.184	1.865~18.731
GA	0.473	0.588	0.672	0.359	1.593	0.562~4.775
Cys-C	2.316	0.675	8.641	0.001	5.972	1.305~10.741
LP-PLA2	0.374	0.104	7.583	0.008	1.725	1.157~3.026
25(OH)D	-0.601	0.142	16.248	0.000	0.129	0.031~0.391
HbA1c、GA、Cys-C、LP-PLA2、25(OH)D：同表 2

下载: 导出CSV

参考文献(19)

[1]	韩睿, 朱钊, 刘华, 等.昆明地区家族性2型糖尿病伴糖尿病视网膜病变患者中血清25羟维生素D₃的检测意义[J].重庆医科大学学报, 2015, 12:1006-1011. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=cqykdxxb201507024
[2]	夏维波.维生素D及其类似物临床应用共识[J].协和医学杂志, 2018, 9:127-143. doi: 10.3969/j.issn.1674-9081.2018.02.007
[3]	刘燕萍, 金洽尔, 包媛媛, 等.妊娠糖尿病孕妇孕中晚期维生素D营养状态及成因分析[J].协和医学杂志, 2017, 8:20-24. doi: 10.3969/j.issn.1674-9081.2017.01.005
[4]	Lucato P, Solmi M, Maggi S, et al.Low vitamin D levels increase the risk of type 2 diabetes in older adults: a systematic review and meta-analysis[J].Maturitas, 2017, 100:8-15. doi: 10.1016/j.maturitas.2017.02.016
[5]	Shen L, Zhuang QS, Ji HF.Assessment of vitaminD levels in type1 and type2 diabetes patients: results from meta-analysis[J].Mol Nutr Food Res, 2016, 60:1059-1067. doi: 10.1002/mnfr.201500937
[6]	胡小磊, 宋宜宁, 张士荣, 等. 2型糖尿病视网膜病变与血清25羟维生素D水平的关系研究[J].蚌埠医学院学报, 2016, 41:574-576. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=bbyxyxb201605005
[7]	American Diabetes Association. Standards of Medical Care in Diabetes-2013[J].Diabetes Care, 2013, 36:S11-S66.
[8]	葛坚.眼科学[M].北京: 人民卫生出版社出版, 2005: 304-305.
[9]	李锦, 李晓华, 王勤.25-羟基维生素D₃水平与2型糖尿病视网膜病变的关系研究[J].河北医药, 2014, 36: 1206-1207. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=hbyy201408040
[10]	张冬艳, 马鸿雁, 苏军燕, 等.血清结缔组织生长因子、25-羟维生素D、脂联素检测在2型糖尿病视网膜病变诊断及病情评价中的价值[J].中国实验诊断学, 2017, 21:505-509 http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgsyzdx201703044
[11]	韩改玲, 鲁娜, 王翠娟, 等. 25(OH)D与2型糖尿病视网膜病变程度的相关性[J].山东医药, 2013, 53:34-35. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=shandyy201309012
[12]	钱超, 余建华, 谷费菲, 等.糖尿病足患者脂蛋白相关磷脂酶A2 D-二聚体及纤维蛋白原水平分析[J].国际检验医学杂志, 2015, 36:3303-3304. doi: 10.3969/j.issn.1673-4130.2015.22.035
[13]	林秀红, 徐明彤, 麦梨芳, 等.新诊断2型糖尿病患者血浆脂蛋白相关性磷脂酶A2及分泌型磷脂酶A2水平与动脉粥样硬化的相关研究[J].中华内分泌代谢杂志, 2016, 32:470-474. doi: 10.3760/cma.j.issn.1000-6699.2016.06.007
[14]	姚建华.糖尿病冠状动脉粥样硬化性心脏病患者测定血清脂蛋白相关磷脂酶A2和血脂水平的临床价值[J].中国血液流变学杂志, 2015, 25:89-92. doi: 10.3969/j.issn.1009-881X.2015.01.030
[15]	唐瑶.青年人血清脂蛋白相关磷脂酶A2水平与胰岛素抵抗的关系及临床意义[D].重庆医科大学, 2015.
[16]	林秀红, 徐明彤, 麦梨芳, 等.短期胰岛素强化治疗对新诊断2型糖尿病患者血浆脂蛋白相关性磷脂酶A2及分泌型磷脂酶A2水平的影响[J].中华内科杂志, 2017, 56:127-129. doi: 10.3760/cma.j.issn.0578-1426.2017.02.009
[17]	孙耀峰, 籍继颖, 刘晓丹, 等.脂蛋白相关磷脂酶A2水平检测对2型糖尿病并发动脉粥样硬化患者的临床意义[J].国际检验医学杂志, 2015, 36:3243-3245. doi: 10.3969/j.issn.1673-4130.2015.22.009
[18]	邓爱红, 黄泽棋, 董少文, 等.老年2型糖尿病患者糖化血红蛋白控制水平与脂蛋白相关磷脂酶A2浓度和肾功能指标变化的临床分析[J].医学检验与临床, 2014, 25:53-55. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=qlyxjy201406021
[19]	吴萍, 殷峻, 刘芳, 等.低25羟维生素D水平与糖尿病视网膜病变的相关性分析[J].中国糖尿病杂志, 2014, 22:220-223. doi: 10.3969/j.issn.1006-6187.2014.03.008

资源附件(0)

WeChat

点击查看大图

表(3)

计量

文章访问数: 546
HTML全文浏览量: 55
PDF下载量: 405
被引次数: 0

/

下载: 全尺寸图片幻灯片

分享

用微信扫码二维码

分享至好友和朋友圈

返回

地址：	北京市东城区帅府园1号北京协和医院老楼7号楼 3层302室《协和医学杂志》编辑部
电话：	010-69154261/4262
E - mail：	medj@pumch.cn mjpumch@126.com
期刊网站版权所有：	《协和医学杂志》编辑部京ICP备 11002662

本系统由北京仁和汇智信息技术有限公司开发

x 关闭永久关闭

【温馨提醒】近日，《协和医学杂志》编辑部接到作者反映，有多名不法人员冒充期刊编辑发送见刊通知，鼓动作者添加微信，从而骗取版面费的行为。特提醒您，本刊与作者联系的方式均为邮件通知或电话，稿件进度通知邮箱为：mjpumch@126.com，编辑部电话为：010-69154261，请提高警惕，谨防上当受骗！如有任何疑问，请致电编辑部核实。谢谢！