2型糖尿病患者血清CTRP9水平与糖尿病视网膜病变的相关性

目的 探讨2型糖尿病（T2DM）患者血清C1q肿瘤坏死因子相关蛋白9（CTRP9）水平与糖尿病视网膜病变(DR)的关系。方法 根据纳入标准收集 291 例 T2DM 患者临床资料，按照眼底检查结果分为 DR 组与非 DR (NDR)组，ELISA 法检测血清CTRP9、脂联素及胰岛素水平。统计分析血清CTRP9水平与T2DM患者、T2DM并发DR患者临床资料的相关性，探讨血清CTRP9水平与T2DM患者并发DR的关系。结果 与NDR组相比，DR组血清CTRP9水平显著升高（P<0.001）；血清脂联素水平显著降低（P<0.001）。Pearson相关性分析显示T2DM并发DR患者中，血清CTRP9水平与DR严重程度呈显著正相关（P<0.05）；与血清脂联素水平呈负相关（P=0.017）。多元Logistic回归分析校正年龄、性别、体重指数、糖尿病病程、糖化血红蛋白、空腹血糖、空腹胰岛素、HOMA-IR、高血压病史、收缩压、低密度脂蛋白、甘油三酯等混杂因素，随着血清CTRP9水平的升高，T2DM并发DR的风险显著升高（P<0.001）。结论 T2DM并发DR患者血清CTRP9水平升高可能是糖尿病视网膜微血管病变的代偿反应。

Association between serum CTRP9 levels and diabetic retinopathy in patients with type 2 diabetes mellitus

Objective To investigate the relationship between serum C1q tumor necrosis factor-related protein 9 (CTRP9) level and the risk of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 291 patients with T2DM underwent fundus examination, and their serum levels of CTRP9, insulin and adiponectin were measured using enzyme-linked immunosorbent assay. According to results of fundus examination, the patients were divided into DR group and non-DR (NDR) group, and logistic regression was used to analyze the relationship between serum CTRP9 levels and DR in T2DM patients. Results Compared with those in NDR group, the patients with DR showed significantly increased serum CTRP9 level (P<0.001) and decreased serum adiponectin level (P<0.001). Pearson correlation analysis showed that in patients with T2DM complicated by DR, serum CTRP9 levels had a significant positive correlation with DR stage (P<0.05) and a negative correlation with serum adiponectin level (P<0.001). Multivariate logistic regression analysis showed that with the increase of serum CTRP9 level, the risk of DR is significantly increased in patients with T2DM. Conclusion In patients with T2DM complicated by DR, an increased serum CTRP9 level suggests a compensatory response to DR.