视黄醇结合蛋白4、中性粒细胞淋巴细胞比值与2型糖尿病视网膜病变的关系

目的  检测视黄醇结合蛋白4（RBP4）及中性粒细胞与淋巴细胞比值（NLR）在2型糖尿病视网膜病变（DR）的表达水平,探讨RBP4、NLR与DR的相关性。方法  选取163例患者作为研究对象,其中单纯2型糖尿病（T2DM）组41例,非增生性2型糖尿病视网膜病变（NPDR）组40例,增生性2型糖尿病视网膜病变（PDR）组42例,40例正常体检人作为对照组（NC）。空腹10 h后检测所有受试者静脉血糖、三酰甘油、胆固醇、低密度脂蛋白、高密度脂蛋白、尿酸、同型半胱氨酸、空腹胰岛素、中性粒细胞与淋巴细胞,计算NLR。稳态模型评估胰岛素抵抗指数。酶联免疫吸附法测定血清RBP4。采用方差分析、相关分析及Logistic逐步回归进行统计学分析。结果  与NC组比较,T2DM组、NPDR组、PDR组RBP4、NLR显著升高,与NPDR组比较RDR组RBP4显著升高（P均<0.05）。RBP4与收缩压、舒张压、空腹血糖、胰岛素抵抗指数、三酰甘油、胆固醇、同型半胱氨酸、NLR呈正相关,与高密度脂蛋白呈负相关（P <0.05）。Logistic回归分析发现收缩压、空腹血糖、RBP4、NLR、胰岛素抵抗、胆固醇为DR的危险因素。结论  RBP4与NLR在DR患者表达水平增高,且NLR可影响DR患者血清RBP4表达,RBP4与NLR是DR的危险因素,与DR相关。

Relationship of serum RBP4 and neutrophil-lymphocyte ratio with type 2 diabetic retinopathy

Objective To detect the expression level of retinol binding protein 4 (RBP4) and neutrophil-lymphocyte ratio (NLR) in type 2 diabetic retinopathy (DR) patients, and to explore the relationship of RBP4 and NLR with DR. Methods A total of 163 subjects were investigated, including 41 cases of type 2 diabetes mellitus (T2DM group), 40 cases of non-proliferative type 2 diabetic retinopathy (NPDR group), 42 cases of proliferative diabetic retinopathy (PDR group) and 40 cases of normal control (NC group). Venous plasma glucose, circulating triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uric acid, homocysteine, neutrophil count and lymphocyte count were detected 10 hours after fasting test; and NLR was calculated. Fasting insulin was measured by electrochemical luminescence, and insulin resistance (HOMA-IR) was determined by homeo-stasis model assessment. Serum RBP4 was measured by enzyme linked immunosorbent assay. Data were statistically analyzed using analysis of variance, correlation analysis and logistic stepwise regression analysis. Results Compared with the NC group, RBP4 and NLR of the T2DM, NPDR and PDR groups significantly increased (P < 0.05), the increase of RBP4 in the PDR group was more significant than that in the NPDR group (P < 0.05). Pearson correlation analysis showed that RBP4 correlated with systolic blood pressure, diastolic blood pressure, fasting blood glucose, HOMA-IR, circulating triglycerides, total cholesterol, homocysteine and NLR; but negatively correlated with high- density lipoprotein cholesterol (P < 0.05). Logistic stepwise regression analysis showed that RBP4, NLR, systolic pressure, fasting blood glucose, HOMA-IR and cholesterol were the risk factors of DR. Conclusions  RBP4 expression level and NLR increase in patients with DR, and NLR can affect serum RBP4 expression in DR patients. RBP4 and NLR are the risk factors for DR, and associated with DR.