血清Fractalkine、Apelin水平与糖尿病视网膜病变患者血糖、血脂以及病程的关系研究

摘要

目的:研究血清Fractalkine(FKN)、爱帕琳肽(Apelin)水平与糖尿病视网膜病变(DR)患者血糖、血脂以及病程的关系.方法:选取我院于2015年1月至2016年12月收治的160例糖尿病患者为研究对象,行眼底荧光造影、裂隙灯显微镜检查,按照检查结果将其区分为非增生型DR组(稳定组,43例)、背景期DR组(背景组,62例)和增殖期DR组(增殖组,55例),另外于同期选取我院40例健康体检者为健康对照组(健康组),测量4组血清FKN、Apelin、空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和总胆固醇(TC)水平,使用Pearson相关性分析分析血清FKN、Apelin与FPG、2hPG、HbA1c、HDL-C、LDL-C、TG、TC、糖尿病病程的相关性.结果:血清FKN、Apelin水平比较:增殖组＞背景组＞稳定组＞健康组,各组间比较差异具有统计学意义(P＜0.05);血清FPG、2hPG、HbA1c、LDL-C、TG、TC水平比较:增殖组＞背景组＞稳定组＞健康组,各组间比较差异具有统计学意义(P＜0.05);血清HDL-C水平比较:健康组＞稳定组＞背景组＞增殖组,各组间比较差异具有统计学意义(P＜0.05);采用Pearson相关性分析显示,血清FKN水平与FPG、2hPG、HbA1c、LDL-C、TG、TC、糖尿病痛程呈正相关性(r=0.321、0.215、0.645、0.154、0.215、0.325、0.578,P＜0.05),与HDL-C呈负相关性(r=-0.547,P＜0.05);血清Apelin水平与FPG、2hPG、HbA1c、LDL-C、TG、TC、糖尿病病程呈正相关性(r=0.245、0.574、0.951、0.357、0.357、0.159、0.546,P＜0.05),与HDL-C呈负相关性(r=-0.459,P＜0.05);糖尿病病程、HbA1c、LDL-C、HDL-C、FKN和Apelin为DR病程的相关影响因素.结论:糖尿病伴发DR患者血清FKN、Apelin水平随着病程的加重逐渐增加,且这两种因子的水平与患者血糖、血脂代谢关系密切.%Objective:To study the relationship between serum Fractalkine (FKN) and Aipalin peptide (Apelin) levels,blood glucose,blood lipids and the course of disease in patients with diabetic retinopathy (DR).Methods:160 patients with diabetes in our hospital from January 2015 to December 2016 were selected as the research object,fundus fluorescein angiography and slit lamp microscopy were performed,and they were divided into non proliferative group DR (stable group,43 cases),background group DR (background group,62 cases) and proliferative stage DR group (proliferation group,55 cases) according to the results of the test,in addition,40 healthy people in our hospital were selected as healthy control group (healthy group) at the same period.The levels of serum FKN,Apelin,fasting blood glucose (FPG),2h postprandial blood glucose (2hPG),glycosylated hemoglobin (HbA1c),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),triglyceride (TG) and total cholesterol (TC) of 4 groups were measured,correlation between serum FKN and Apelin with FPG,2hPG,HbA1c,HDL-C,LDL-C,TG,TC and the course of diabetes was analyzed by Pearson correlation analysis.Results:The levels of serum FKN and Apelin were compared:proliferation group＞background group＞ stable group＞healthy group,the difference between each group was statistically significant (P＜0.05).The levels of serum FPG,2hPG,HbA1c,LDL-C,TG and TC were compared:proliferation group＞ background group＞stable group＞healthy group,the difference between each group was statistically significant (P＜0.05).The levels of serum HDL-C were compared:healthy group＞ stable group＞background group＞proliferation group,the difference between each group was statistically significant (P＜0.05).Pearson correlation analysis showed that the level of serum FKN was positively correlated with level of FPG,2hPG,HbAlc,LDL-C,TG,TC,the course of diabetes (r=0.321,0.215,0.645,0.154,0.215,0.325,0.578,P＜0.05),and there was a negative correlation with HDL-C (r=-0.547,P＜0.05).The serum levels of Apelin was positively correlated with FPG,2hPG,HbA1c,LDL-C,TG,TC,the course of diabetes (r=0.245,0.574,0.951,0.357,0.357,0.159,0.546,P＜0.05),and there was a negative correlation with HDL-C(r=-0.459,p＜0.05).The course of diabetes,HbA1c,LDL-C,HDL-C,FKN and Apelin were related factors influencing the course of DR.Conclusion:The levels of serum FKN and Apelin are increased gradually with the aggravation of the course of disease in patients with diabetes mellitus accompanied by DR,and the levels of the two factors are closely related to blood glucose and blood lipid metabolism of patients.