2型糖尿病患者血浆氧化三甲胺与视网膜病变的相关性

 目的 探讨2型糖尿病(T2DM)患者血浆氧化三甲胺(TMAO)与视网膜病变(DR)的相关性。方法 选择航天中心医院内分泌科T2DM患者101例,分为DR组(n=32)和无DR组(n=69)。采用ELISA法测定血浆TMAO浓度,采用Logistic回归和ROC曲线分析血浆TMAO与DR的关系。结果 DR组患者的年龄、糖尿病病程、收缩压、血浆TMAO均大于无DR组(P＜0.05),而血白蛋白、三酰甘油低于无DR组(P＜0.05)。Logistic回归分析显示,调整相关混杂因素后,年龄(OR=1.070, 95%CI:1.011～1.133, P=0.019)、血白蛋白(OR=0.807, 95%CI:0.701～0.929, P=0.003)、TMAO(OR=1.062, 95%CI:1.006～1.121, P=0.029)是DR的危险因素。ROC曲线显示单独血浆TMAO预测DR的曲线下面积(AUC)为0.650(P=0.024),年龄、血白蛋白、TMAO联合的AUC为0.789(P＜0.001)。结论 DR患者表现出更高水平的血浆TMAO,TMAO是DR的相关危险因素,TMAO联合年龄、血白蛋白等对DR有较高的预测价值。

Correlation between plasma TMAO level and DR in patients with T2DM

Objective To investigate the correlation of plasma trimethylamine-N-oxide (TMAO) level with diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).Methods One hundred and one patients with T2DM admitted into the endocrinology department of Aerospace Center Hospital were enrolled in this study and divided into DR group (n=32) and without-DR group (n=69). Plasma TMAO level was measured by the ELISA method, and the Logistic regression and receiver operating characteristic (ROC) curve were used to analyze the relationship between plasma TMAO level and DR.Results The DR patients were older and showed higher duration of diabetes, systolic blood pressure and plasma TMAO level than without-DR group (P＜0.05), while serum albumin and triglycerides in DR group were lower (P＜0.05). Logistic regression analysis found that, after adjustment for confounding factor, the age (OR=1.070, 95%CI:1.011-1.133, P=0.019), serum albumin (OR=0.807, 95%CI:0.701-0.929, P=0.003), and plasma TMAO (OR=1.062, 95%CI:1.006-1.121,P=0.029) were independently associated with DR. Based on ROC analysis, the area under curve (AUC) of plasma TMAO alone was 0.650(P=0.024), and the AUC of age, serum albumin and plasma TMAO in combination was 0.789(P＜0.001).Conclusion DR patients show a higher plasma TMAO level. The combination of plasma TMAO, age and serum albumin is characterized by a higher predicting ability for DR.