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

  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.