老年糖尿病视网膜病变瘦素水平与颈动脉内中膜厚度的相关性

目的了解老年糖尿病视网膜病变(DR)血清瘦素水平与颈动脉内中膜厚度(IMT)的相关性。方法老年糖尿病无视网膜病变(DM-NDR)组60例;DR组62例,其中非增殖性视网膜病变(NPDR)40例及增殖性视网膜病变(PDR)组22例;健康对照组60名,测定血清瘦素、颈动脉IMT及斑块等,进行瘦素水平与其他指标的相关性分析。结果老年DM-DR组瘦素水平高于DM-NDR组(t=3.21,P<0.01);PDR组血清瘦素浓度高于NPDR组(t=2.23,P<0.05)、NDR组(t=2.85,P<0.01)。老年DM-DR组颈动脉IMT厚度较DM-NDR组增厚(t=2.38,P<0.05)。在以瘦素水平为因变量的Logistic多元回归分析中,入选的变量为:病程(β=0.353,P=0.026)、BMI(β=0.2813,P=0.004)、HOMA-R(β=0.189,P=0.009)、IMT(β=1.109,P=0.043)。结论老年DM患者血清瘦素水平与IMT显著相关。瘦素水平受病程、BMI、HOMA-R、IMT影响,可以反映DR的进展过程和严重程度。

Correlation between serum leptin levei and intimai media thickness in type 2 diabetic retinopathy

Objective To investigate the correlation between serum leptin level and intimal media thickness (IMT) in type 2 diabetic retinopathy (DR). Methods 182 subjects were allocated to four groups, which included 60 cases of diabetes without retinopathy (DM-NDR group), 40 cases of non-proliferative diabetic retinopathy (NPDR group), 22 cases of proliferative diabetic retinopathy (PDR group) and 60 healthy individuals (control group). The levels of serum leptin, carotid IMT and plaques were measured and analyzed for their correlations with serum leptin level and other parameters. Results The patients with DR had higher serum leptin levels than those in DM-NDR group (t=3.21, P<0.01). The PDR group showed higher serum leptin level than the NPDR group (t=2.23, P<0.05). The patients with DR had thicker IMT than those with DM-NDR (t=2.38, P<0.05). Multiple Logistic regression analyses showed the serum lep- tin level were positively correlated to duration of disease (β=0.353,P=0.026), BMI (β= 0.2813, P=0.004), HOMA-R (β= 0.189, P=0.009) and IMT (β=1.109, P=0.043). Conclusion Serum leptin level was showed to be associated with IMT in elder patients with diabetes. Correlation between serum leptin with duration of disease, BMI, HOMA-R and IMT sug- gested that serum leptin may be used as an indicator of DR progression and severity.