中国全科医学Issue(35)：4288-4292,5.DOI:10.3969/j.issn.1007-9572.2015.35.004
社区中老年糖尿病患者泪液和血清肿瘤坏死因子α及血清糖化血红蛋白与糖尿病视网膜病变的关系
Relationship Between the Levels of Tear Fluid TNF-α,Serum TNF-αand Serum HbA1c and Diabetic Retinopathy in ;Middle - aged and Elderly Diabetes Patients
摘要
Abstract
Objective To investigate the relationship between the severity of diabetic retinopathy( DR)in middle-aged and elderly diabetes patients and the levels of tear fluid TNF-α, serum TNF-α and serum HbA1c in Shijiazhuang. Methods From April to October in 2011,we selected 9 community residents(resident years≥5,age≥45)in Shijiazhuang using stratified random sampling. According to diagnostic criteria,the patients were definitely diagnosed and determined with different phrases. Venous blood was sampled,and FPG,2 hPG,blood lipid,TNF-α and HbA1c were determined. Capillary glass tube method was employed,and ELISA was employed to determine TNF-αlevel. Results A total of 1 447 patients were included,among which 467 had normal glucose tolerance ( NGT ) and 593 had DM;among subjects who received fundus examination and offered tear samples,105 subjects had NGT(210 eyes,NGT group),184 subjects had diabetes without retinopathy(368 eyes,NDR group),149 had non-proliferating diabetic retinopathy(298 eyes,NPDR group),and 63 had proliferative diabetic retinopathy(126 eyes,PDR group). The 4 groups were significantly different in BMI,WHR,SBP, DBP,FPG,TC,TG,HDL-C and LDL-C( P ﹤0. 01 for all). NGT group,NDR group,NPDR group and PDR group were significantly different in the levels of tear fluid TNF-α,serum TNF-α and serum HbA1c ( P ﹤0. 05 for all). NDR group,NPDR group and PDR group were higher than NGT group in the levels of tear fluid TNF-α,serum TNF-αand serum HbA1c ( P﹤0. 05 for all);NPDR group and PDR group were higher than NDR group in the levels of tear fluid TNF-α,serum TNF-α and serum HbA1c ( P﹤0. 05 for all);PDR group was higher than NPDR group in the levels of tear fluid TNF-α, serum TNF-α and serum HbA1c ( P﹤0. 05 for all). The level of tear fluid TNF-α was positively correlated with the level of serum TNF-α(b =0. 291,t =29. 28,P ﹤0. 01). Tear fluid TNF-α was positively correlated with serum HbA1c(b =1. 480,t=7. 58,P ﹤0. 01). Multivariate Logistic regression analysis showed that age,gender,history of diabetes,BMI, WHR,TG,FPG,2 hPG, tear fluid TNF-α, serum TNF-α and HbA1c were influencing factors for DR ( P ﹤0. 05 ). Conclusion Middle-aged and elderly residents with type 2 diabetes have higher tear fluid TNF-αlevel than healthy middle-aged and elderly residents. With the exacerbation of retinopathy,the tear fluid TNF-α level increases. The levels of tear fluid TNF-α,serum TNF-α and serum HbA1c may reflect the severity of DR to some extent.关键词
糖尿病/糖尿病视网膜病变/泪液/血清/肿瘤坏死因子αKey words
Diabetes mellitus/Diabetic retinopathy/Tear fluid/Serum/Tumor necrosis factor-alpha分类
医药卫生引用本文复制引用
王伟超,张洁,王虹,刘素波,王欣,吴韬,梁屹,任巧华..社区中老年糖尿病患者泪液和血清肿瘤坏死因子α及血清糖化血红蛋白与糖尿病视网膜病变的关系[J].中国全科医学,2015,(35):4288-4292,5.基金项目
石家庄市科学技术研究与发展指导计划项目 （）
