[1]赵庆芳,魏会宇,胡丽影.2型糖尿病患者糖尿病视网膜病变程度与肾功能指标的相关性[J].眼科新进展,2018,38(5):471-474.[doi:10.13389/j.cnki.rao.2018.0110]
 ZHAO Qing-Fang,WEI Hui-Yu,HU Li-Ying.Correlation between the degree of diabetic retinopathy and renal function in patients with type 2 diabetes mellitus[J].Recent Advances in Ophthalmology,2018,38(5):471-474.[doi:10.13389/j.cnki.rao.2018.0110]
点击复制

2型糖尿病患者糖尿病视网膜病变程度与肾功能指标的相关性/HTML
分享到:

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年5期
页码:
471-474
栏目:
应用研究
出版日期:
2018-05-05

文章信息/Info

Title:
Correlation between the degree of diabetic retinopathy and renal function in patients with type 2 diabetes mellitus
作者:
赵庆芳魏会宇胡丽影
300384 天津市,天津医科大学眼科医院药剂科(赵庆芳,魏会宇);300384 天津市,天津医科大学眼科医院糖网中心(胡丽影)
Author(s):
ZHAO Qing-FangWEI Hui-YuHU Li-Ying
Department of Pharmacy,Eye Hospital of Tianjin Medical University(ZHAO Qing-Fang,WEI Hui-Yu),Tianjin 300384,China;Diabetic Retinopathy Center,Eye Hospital of Tianjin Medical University(HU Li-Ying),Tianjin 300384,China
关键词:
2型糖尿病糖尿病视网膜病变肾功能相关性
Keywords:
type 2 diabetes mellitusdiabetic retinopathyrenal functioncorrelation
分类号:
R774.1
DOI:
10.13389/j.cnki.rao.2018.0110
文献标志码:
A
摘要:
目的 观察2型糖尿病患者糖尿病视网膜病变(diabetic retinopathy,DR)程度与肾功能相关指标间的关系。方法 回顾性分析2016年1月至10月来本院眼科就诊的189例(189眼)2型糖尿病患者,根据DR诊断标准将其分为无视网膜病变组(NDR组101眼)和视网膜病变组(DR组88眼)。DR组根据病变程度分为轻度非增生型DR组(轻度NPDR组31眼)、中度NPDR组(26眼)、重度NPDR组(19眼)和增生型DR组(PDR组12眼),检测患者肾功能相关指标,分析2型糖尿病患者DR病变程度与肾功能相关指标的关系。结果 DR组患者尿白蛋白/尿肌酐比值(urinary albumin/creatinine,UACR)、血清肌酐(serum creatinine,Scr)、胱抑素C(serum cystatin C,sCys-C)表达水平[(281.36±98.37)mg·g-1、(78.31±16.08)μmol·L-1、(1.17±0.32)mmol·L-1]显著高于NDR组[(183.16±84.17)mg·g-1、(62.47±15.21)μmol·L-1、(0.83±0.21)mmol·L-1],差异均有统计学意义(均为P<0.05);而DR组患者肾小球滤过率(glomerular filtration rate,GFR)表达水平(80.81±23.21)mL·min-1显著低于NDR组(89.83±20.13)mL·min-1,差异有统计学意义(P<0.05)。随着病情加重DR患者UACR、Scr和sCys-C表达水平逐渐增加,而GFR表达水平逐渐降低,四组间差异有统计学意义(P<0.05)。PDR组患者各指标与轻度NPDR组和中度NPDR组差异均有统计学意义(均为P<0.05)。DR病变程度与UACR、Scr和sCys-C均呈正相关(均为P<0.05),与GFR呈负相关(P<0.05)。结论 2型糖尿病患者DR的病变程度与肾功能指标密切相关,UACR、Scr和sCys-C升高及GFR降低是DR发生的危险因素。
Abstract:
Objective To investigate the relationship between the degree of diabetic retinopathy (DR) and renal function in patients with type 2 diabetes mellitus (T2DM).Methods Totally 189 cases of patients (189 eyes) with T2DM from January 2016 to October 2016 were enrolled in the study.According to the diagnostic criteria of DR,the patients were divided into non-DR group (NDR group,101 eyes) and DR group (88 eyes).And the patients in the DR group was subgrouped into mild non-proliferative DR (NPDR) group (31 eyes),moderate NPDR group (26 eyes),severe NPDR group (19 eyes) and proliferative DR (PDR) group (12 eyes) according to the severity.And the renal function related variables were detected,and the relationship between the degree of DR and renal function in T2DM patients was evaluated.Results The levels of urinary albumin/creatinine ratio (UACR),serum creatinine (SCr) and serum cystatin C (sCys-C) was (281.36±98.37)mg·g-1,(78.31±16.08)μmol·L-1 and (1.17±0.32)mmol·L-1 in group DR,which were significantly higher than those in group NDR [(183.16±84.17)mg·g-1,(62.47±15.21)μmol·L-1 and (0.83±0.21)mmol·L-1] (all P<0.05),while the level of glomerular filtration rate (GFR) was (80.81±23.21)mL·min-1 in DR group,which was lower than that of group NDR (89.83±20.13)mL·min-1 (P<0.05).The levels of UACR,Scr and sCys-C increased gradually, while the level of GFR decreased gradually with the degree of DR progressing,and there were statistical differences in the levels of UACR,Scr,sCys-C and GFR in the four groups (all P<0.05).Furthermore,the differences in above variables in PDR group with mild NPDR and moderate NPDR were statistically significant (all P<0.05).Spearman rank correlation analysis showed that the degree of DR was positively correlated with UACR,Scr and sCys-C (all P<0.05),and negatively correlated with GFR (P<0.05).Conclusion The degree of DR in T2DM patients is closely related to the index of renal function,and elevated UACR,Scr and Cys-C and decreased GFR are the risk factors for DR.

参考文献/References:

[1] ZHANG HY,WANG JY,YING GS,SHEN LP,ZHANG Z.Diabetic retinopathy and renal function in Chinese type 2 diabetic patients[J].Int Urol Nephrol,2014,46(7):1375-1381.
[2] SENTHILKUMAR GP,ANITHALEKSHMI MS,YASIR M,PARAMESWARAN S,PACKIRISAMY RM,BOBBY Z.Role of omentin 1 and IL-6 in type 2 diabetes mellitus patients with diabetic nephropathy[J].Diabetes Metab Syndr,2018,12(1):23-26.
[3] LIU Y,YANG JR,TAO LY,LV HB,JIANG XD,ZHANG MZ,et al.Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy:a cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China[J].BMJ Open,2017,7(9):e016280.
[4] MIAO Y,YAN L,ZHU Q,CAO HX,CHU TS,SHAO FM.Effect of lipoprotein-associated phospholipase A2 level on urinary albumin excretion rate and serum creatinine in diabetic nephropathy patients[J].J Xinxiang Med Univ,2015,32(6):522-525.
苗艳,阎磊,朱清,曹慧霞,楚天舒,邵凤民.血清脂蛋白相关磷脂酶A2水平对糖尿病肾病患者尿白蛋白排泄率和血肌酐的影响[J].新乡医学院学报,2015,32(6):522-525.
[5] HU JP,WANG T,WENG XG.Effect of liraglutide and exenatide on renal structure and function of diabetic nephropathy rats[J].J Xinxiang Med Univ,2017,34(4):255-260.
胡俊鹏,王涛,翁孝刚.利拉鲁肽和艾塞那肽对2型糖尿病肾病大鼠肾脏结构和功能的影响[J].新乡医学院学报,2017,34(4):255-260.
[6] PARK CW.Diabetic kidney disease:from epidemiology to clinical perspectives[J].Diabetes Metab J,2014,38(4):252-260.
[7] JENG CJ,HSIEH YT,YANG CM,YANG CH,LIN CL,WANG JI.Diabetic retinopathy in patients with diabetic nephropathy:development and progression[J].PLoS One,2016,11(8):e161897.
[8] The Ocular Fundus Diseases Group of Chinese Ophthalmological Society.The chinese guideline of diabetic retinopathy(2014) [J].Chin J Ophthalmol,2014,50(11):851-865.
中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865.
[9] Chinese Diabetes Society.2013 Chinese guidelines for the management of Type 2 diabetes mellitus[J].Chin J Diabetes,2014,6(7):447-498.
中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,6(7):447-498.
[10] GEORGE LK,MOLNAR MZ,LU JL,KALANTAR-ZADEH K,KOSHY SK,KOVESDY CP.Association of pre-operative albuminuria with post-operative outcomes after coronary artery bypass grafting[J].Sci Rep,2015,5:16458.
[11] Microvascular complication group of diabetes credits of Chinese Medical Association.2014 expert consensus on prevention and treatment of diabetic nephropathy[J].Chin J Diabetes,2014,6(11):792-801.
中华医学会糖尿病学分会微血管并发症学组.糖尿病肾病防治专家共识(2014年版)[J].中国糖尿病杂志,2014,6(11):792-801.
[12] PEDRO RA,RAMON SA,MARC BB,JUAN FB,ISABEL MM.Prevalence and relationship between diabetic retinopathy and nephropathy,and its risk factors in the North-East of Spain,a population-based study[J].Ophthalmic Epidemiol,2010,17(4):251-265.
[13] HOU Q,HU K,LIANG JY,WANG M.Clinical value of detection of many markers in the early diabetic nephropathy[J].Chin J Mod Med,2014,24(30):49-52.
侯茜,胡可,梁捷予,王敏.多项指标联合检测对早期糖尿病肾病的临床价值[J].中国现代医学杂志,2014,24(30):49-52.
[14] LIANG LJ,HONG BJ,FANG YQ,ZHANG MX.The clinical value of combined detection of serum Cys C,RBP and NEFA in the early diagnosis of type 2 diabetic nephropathy[J].Chin J Health Lab Tec,2015,25(4):524-525.
梁丽娟,洪宝建,方亚奇,张敏霞.血清CysC、RBP、NEFA联合检测在2型糖尿病肾病早期诊断中的临床价值[J].中国卫生检验杂志,2015,25(4):524-525.
[15] PEROL J,BALKAU B,GUILLAUSSEAU PJ,MASSIN P.A study of the 3-year incidence of diabetic retinopathy in a French diabetic population seen at Lariboisiere Hospital,Paris[J].Diabetes Metab,2012,38(3):225-229.
[16] PENNO G,SOLINI A,ZOPPINI G,ORSI E,ZERBINI G,TREVISAN R,et al.Rate and determinants of association between advanced retinopathy and chronic kidney disease in patients with type 2 diabetes:the Renal Insufficiency And Cardiovascular Events(RIACE) Italian multicenter study[J].Diabetes Care,2012,35(11):2317-2323.
[17] LEE WJ,SOBRIN L,LEE MJ,KANG MH,SEONG M,CHO H.The relationship between diabetic retinopathy and diabetic nephropathy in a population-based study in Korea(KNHANES V-2,3)[J].Invest Ophthalmol Vis Sci,2014,55(10):6547-6553.
[18] WANG YZ,LIU HF.Clinical analysis of correlation between renal function and occurrence of retinopathy in patients with type 2 diabetes mellitus[J].Int Eye Sci,2017,17(1):107-109.
王养忠,柳红芳.2型糖尿病患者肾功能相关指标与发生视网膜病变的相关性[J].国际眼科杂志,2017,17(1):107-109.
[19] LI ST,WANG XN,DU XH,WU Q.Relationship between glomerular filtration rate and diabetic retinopathy in type 2 diabetic patients[J].Chin J Ocul Fundus Dis,2017,33(3):244-248.
李淑婷,王相宁,杜新华,吴强.2型糖尿病患者糖尿病视网膜病变与肾小球滤过率的相关性研究[J].中华眼底病杂志,2017,33(3):244-248.
[20] QIAN C,WAN GM,YAN PS,WANG WZ,LIANG SZ,DONG Y.Correlation between Cystatin C and retinopathy of type-two diabetes mellitus patients[J].J Biol Regul Homeost Agents,2017,31(1):99-103.
[21] MAN RE,SASONGKO MB,WANG JJ,MACISAAC R,WONG TY,SABANAYAGAM C,et al.The association of estimated glomerular filtration rate with diabetic retinopathy and macular edema [J].Invest Ophthalmol Vis Sci,2015,56(8):4810-4816.
[22] AHSAN H.Diabetic retinopathy--biomolecules and multiple pathophysiology[J].Diabetes Metab Syndr,2015,9(1):51-54.
[23] LI B,ZHANG Y,GUO B.Relationship between urinary albumin creatinine ratio and retinopathy in patients with type 2 diabetes mellitus[J].J Guiyang Med Coll,2014,39(2):247-249.
李斌,张跃,郭兵.尿白蛋白肌酐比值与2型糖尿病患者视网膜病变的关系[J].贵阳医学院学报,2014,39(2):247-249.

相似文献/References:

[1]杜玮 刘子扬 周艳艳 雒雷鸣.糖尿病视网膜病变与血清胆红素水平的关系[J].眼科新进展,2012,32(5):000.
[2]范松涛 卢建民.阿司匹林与糖尿病患者玻璃体出血以及玻璃体切割术疗效的相关性研究[J].眼科新进展,2012,32(11):000.
[3]叶芬 王春红 陈银 施宇华 黄振平.人工泪液对糖尿病干眼患者泪河的影响[J].眼科新进展,2012,32(12):000.
[4]李艳 李筱荣 袁佳琴 潘斌.糖尿病大鼠视网膜中VEGF、PEDF的表达与血-视网膜屏障损伤[J].眼科新进展,2013,33(1):000.
[5]马兰茗 金喜浓 金丽.光学相干断层扫描测量下方泪河高度诊断2型糖尿病患者眼干燥症的可行性[J].眼科新进展,2013,33(2):000.
[6]李朝晖 崔治华 胡晓英 孟丽珠 张敬维.糖尿病视网膜病变激光面积与疗效的分析[J].眼科新进展,2013,33(2):000.
[7]冯冬梅 朱鸿 施彩虹.CXC趋化因子及其受体在糖尿病视网膜病变中的作用[J].眼科新进展,2013,33(6):000.
[8]牛淑玲.糖尿病视网膜病变患者HbAlc、FPG与血小板参数的变化及危险因素分析[J].眼科新进展,2013,33(7):000.
[9]毕春潮 王睿 王建洲 雷春灵 董晓娟 王小莉 薛晓辉.Ad-PEDF对糖尿病视网膜病变大鼠视网膜新生血管的抑制作用[J].眼科新进展,2013,33(8):000.
[10]杨萍 孙书明 李晓鹏.辛伐他汀对糖尿病视网膜病变和炎症因子的影响[J].眼科新进展,2013,33(8):000.
[11]刘银萍 胡水旺 吴贞凤 梅立新 郎平 陆晓和.糖尿病视网膜病变患者血清β2-糖蛋白Ⅰ的表达[J].眼科新进展,2012,32(2):000.
[12]杨萍,孙书明.血清25羟维生素D3水平与2型糖尿病视网膜病变的关系研究[J].眼科新进展,2014,34(6):583.[doi:10.13389/j.cnki.rao.2014.0161]
[13]屠永芳,王一鹏,孙书明,等. 人眼玻璃体内CXC配体16与2型糖尿病视网膜病变的关系[J].眼科新进展,2015,35(4):371.[doi:10.13389/j.cnki.rao.2015.0100]
 TU Yong-Fang,WANG Yi-Peng,SUN Shu-Ming,et al. Relationship between intravitreal CXC ligand 16 and type 2 diabetic retinopathy[J].Recent Advances in Ophthalmology,2015,35(5):371.[doi:10.13389/j.cnki.rao.2015.0100]
[14]李涛,吴小利,刘兴德,等.糖尿病视网膜病变与外周血管和心血管病变的相关性研究[J].眼科新进展,2020,40(2):173.[doi:10.13389/j.cnki.rao.2020.0041]
 LI Tao,WU Xiaoli,LIU Xingde,et al.Correlation of diabetic retinopathy with peripheral vascular disease and cardiovascular disease[J].Recent Advances in Ophthalmology,2020,40(5):173.[doi:10.13389/j.cnki.rao.2020.0041]
[15]胡佳琪,周倩倩,徐慧君,等.HbA1c变异性对糖尿病视网膜病变的影响及其截断值的判定[J].眼科新进展,2020,40(10):967.[doi:10.13389/j.cnki.rao.2020.0217]
 HU Jiaqi,ZHOU Qianqian,XU Huijun,et al.Effect of HbA1c variability on diabetic retinopathy and its cut-off value for early diabetic retinopathy diagnosis[J].Recent Advances in Ophthalmology,2020,40(5):967.[doi:10.13389/j.cnki.rao.2020.0217]
[16]罗云霞,余曦,田敏,等.叔丁基对苯二酚(tBHQ)对2型糖尿病大鼠视网膜的长期保护作用[J].眼科新进展,2021,41(1):032.[doi:10.13389/j.cnki.rao.2021.0007]
 LUO Yunxia,YU Xi,TIAN Min,et al.Long-term protective effect of tert-butyl hydroquinone on the retina of type 2 diabetic rats[J].Recent Advances in Ophthalmology,2021,41(5):032.[doi:10.13389/j.cnki.rao.2021.0007]
[17]万伟伟,龙洋,刘宏卓,等.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[J].眼科新进展,2021,41(5):447.[doi:10.13389/j.cnki.rao.2021.0093]
 WAN Weiwei,LONG Yang,LIU Hongzhuo,et al.Correlation between plasma melatonin levels and diabetic retinopathy secondary to type 2 diabetes[J].Recent Advances in Ophthalmology,2021,41(5):447.[doi:10.13389/j.cnki.rao.2021.0093]
[18]许慕东,朱妍,蔡骐,等.总胆红素水平与糖尿病黄斑水肿发病及严重程度的相关性[J].眼科新进展,2023,43(3):216.[doi:10.13389/j.cnki.rao.2023.0044]
 XU Mudong,ZHU Yan,CAI Qi,et al.Correlation between total bilirubin level and occurrence and severity of diabetic macular edema[J].Recent Advances in Ophthalmology,2023,43(5):216.[doi:10.13389/j.cnki.rao.2023.0044]
[19]唐娟,李庆华,邓秀英,等.通过卷积神经网络分析ECT成像和临床检验数据评估糖尿病视网膜病变和糖尿病肾病之间的相关性[J].眼科新进展,2024,44(2):127.[doi:10.13389/j.cnki.rao.2024.0025]
 TANG Juan,LI Qinghua,DENG Xiuying,et al.Evaluation of the correlation between diabetic retinopathy and diabetic nephropathy by emission computed tomography and clinical testing data via convolutional neural network[J].Recent Advances in Ophthalmology,2024,44(5):127.[doi:10.13389/j.cnki.rao.2024.0025]

更新日期/Last Update: 2018-05-09