中国全科医学2016，Vol.19Issue(33)：4046-4050,5.DOI:10.3969/j.issn.1007-9572.2016.33.005
血糖控制达标的2型糖尿病患者25羟维生素 D3与胰岛素样生长因子Ⅰ水平分析及其与糖尿病视网膜病变的关系研究
Analysis of the Level of 25 Hydroxy Vitamin D3 and Insulin - like Growth Factor Ⅰ in Well - controlled Type 2 Diabetes and the Association between Them and Diabetic Retinopathy
摘要
Abstract
Background Diabetic retinopathy(DR)caused serious damage to visual function in diabetic mellitus, but the pathogenesis of DR was still unknown. Objective To analyse the level of 25 hydroxy vitamin D3〔25(OH)D3〕and insulin - like growth factor(IGF-Ⅰ)in well - controlled type 2 diabetes(T2DM)and explore the association between them and DR. Methods 128 patients followed up for 3 years in the First Affiliated Hospital of Xinjiang Medical University and the Armed Police Hospital of Xinjiang from January 2012 to June 2015, with well - controlled T2DM, were retrospectively enrolled. According to International Clinical Classification Criteria for Diabetic Retinopathy(2002),all patients were examined by fundus fluorescein angiography and divided into three groups:normal group( control group,74 cases ),non proliferative retinopathy(NPDR,31 cases )and proliferative retinopathy(PDR,23 cases). General information〔including gender,age, diabetes duration,abdomen circumference,body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure (DBP)〕and laboratory indexes〔including growth hormone(GH),IGF-Ⅰ,fasting plasma glucose(FPG),fasting C peptide (FC-P),2 h postprandial( 2 hPG),2 h postprandial blood glucose C peptide( 2 hC-P),25 ( OH)D3 ,low density lipoprotein cholesterol(LDL-C),triglyceride(TG),high - density lipoprotein cholesterol(HDL-C),total cholesterol(TC) and microalbuminuria〕in the three groups were collected and compared. The risk factors of DR in T2DM were evaluated using multi - factor Logistic regression analysis. Results There were no significant differences in gender, age, abdomen circumference,BMI,SBP and DBP among three groups( P > 0. 05). The duration of diabetes in control group and NPDR group was shorter than the PDR group(P < 0. 05). There were no significant differences in level of FPG,2 hPG,TG,HDL-C and TC among three groups( P > 0. 05). The level of GH,IGF-Ⅰ,LDL-C and microalbuminuria in PDR group was higher than NPDR and control group(P < 0. 05). The level of FC-P,2 hC-P,25(OH)D3 in the PDR group was lower than the control group and the NPDR group( P < 0. 05). The level of 25(OH)D3 in the NPDR was lower than the control group (P < 0. 05 ) . Multivariate Logistic regression analysis showed that, diabetes duration 〔 OR = 1. 811,95% CI ( 1. 270, 2. 632)〕, IGF-Ⅰ 〔 OR = 1. 211,95% CI ( 1. 121,1. 380 )〕, FC-P 〔 OR = 1. 049,95% CI ( 1. 012,1. 098 )〕, 25(OH)D3〔OR = 1. 788,95% CI(1. 072,2. 102)〕and microalbuminuria〔 OR = 4. 137,95% CI(1. 455,11. 211)〕were independent risk factors for DR in T2DM patients(P < 0. 05). Conclusion In addition to the common risk factors,such as diabetes duration,SBP,LDL-C,FC-P and microalbuminuria,decreased serum 25(OH)D3 and increased serum IGF-Ⅰare also associated with DR,which may be one of the mechanisms for the progress of DR in patients with T2DM.关键词
糖尿病视网膜病变/糖尿病,2 型/骨化二醇/胰岛素样生长因子ⅠKey words
Diabetic retinopathy/Diabetes mellitus,type 2/Calcifediol/Insulin - like growth factor Ⅰ分类
医药卫生引用本文复制引用
张莉,马岩萍,蒋升..血糖控制达标的2型糖尿病患者25羟维生素 D3与胰岛素样生长因子Ⅰ水平分析及其与糖尿病视网膜病变的关系研究[J].中国全科医学,2016,19(33):4046-4050,5.基金项目
新疆维吾尔自治区自然科学基金资助项目 （）
