2型糖尿病患者血浆褪黑素水平与糖尿病视网膜病变的相关性研究

目的 探究2型糖尿病患者血浆褪黑素水平与糖尿病视网膜病变(DR)的相关性,为DR的诊断提供新思路.方法 前瞻性病例对照研究.收集2020年5月至10月于郑州大学第一附属医院筛查糖尿病者300人,其中体检确诊无糖尿病的健康人群为对照组(118人)、确诊为2型糖尿病并于眼科就诊的患者为研究组(182例).根据2019年的糖...

Correlation between plasma melatonin levels and diabetic retinopathy secondary to type 2 diabetes

Objective　To explore the correlation between plasma melatonin and diabetic retinopathy (DR) in patients with type 2 diabetes to provide new ideas for the diagnosis and treatment of DR.Methods　Prospective case-control study. Diabetes patients were screened in the First Affiliated Hospital of Zhengzhou University from May 2020 to October 2020, and healthy people without diabetes confirmed by physical examination were included as the control group (118 individuals). Patients diagnosed with type 2 diabetes and treated in the ophthalmology department were the study group (182 patients). According to the diabetic retinopathy preferred practice pattern (DR PPP)-updated 2019 criteria, DR was diagnosed and graded. Based on the results of fundus examination, the 182 patients were divided into 3 subgroups, including the non-DR group (NDR group, 57 patients), the non-proliferating DR group (NPDR group, 64 patients), and the proliferating DR group (PDR group, 61 patients). The plasma melatonin level in each group was detected by ELISA kit to evaluate the relationship between plasma melatonin level and the risk and severity of DR. The differences of triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), total bilirubin (Tb), hypersensitive C-reactive protein (hs-CRP), homocysteine (Hcy), parathyroid hormone (PTH) and 25-hydroxyvitamin D3 ［25(OH)VitD3］ in each group were compared.Results　The plasma melatonin levels of the control group, NDR group, NPDR group and PDR group were (72.83±16.25) ng·L^-1, (60.38±13.43) ng·L^-1, (44.48±10.30) ng·L^-1, and (44.69±8.95) ng·L^-1, and the differences among groups were statistically significant (P<0.001). Besides, plasma melatonin can be used as a potential biomarker for the diagnosis of DR (AUC=0.893, P<0.001). There was a significant positive correlation between serum Tb and melatonin content in all participants (P<0.001), and there was also a significant positive correlation between serum Tb and melatonin content in NPDR group and PDR group (R²=0.360, P<0.001). The increase of Tb and hs-CRP and the decrease of 25(OH)VitD3 were related to the development of DR. There was statistically significant difference in Hcy among different study groups (P<0.05).Conclusion　The plasma melatonin concentration in DR patients is decreased, and the plasma melatonin can be used as a sensitive and specific indicator for the diagnosis of DR, and there is a significant positive correlation between Tb and melatonin.