【摘要】 目的探讨2型糖尿病(T2DM)视网膜病变(DR)患者血清锌-α2-糖蛋白(ZAG)水平及其临床意义。方法选取227例T2DM患者作为研究对象,根据DR分期分为单纯T2DM组(T2DM组)76例、非增殖期糖尿病视网膜病变(NPDR)组82例、增殖期糖尿病视网膜病变(PDR)组69例。另选同期70例健康体检者作为对照组。比较4组的临床指标、ZAG水平、糖脂代谢及肝肾功能指标,并分析DR患者ZAG水平与临床指标相关性及其影响因素。结果对照组、T2DM组、NPDR组、PDR组的ZAG水平依次降低,空腹血糖、糖化血红蛋白(HbA1c)、稳态模型胰岛素抵抗(HOMA-IR)指数依次升高(均P<0.05)。DR患者血清ZAG水平与糖尿病病程、收缩压、体质指数、总胆固醇、三酰甘油、空腹血糖、HbA1c、空腹胰岛素、HOMA-IR指数呈负相关(均P<0.05)。HbA1c、三酰甘油、HOMA-IR指数、体质指数是DR患者ZAG水平的独立影响因素(均P<0.05)。结论 DR患者的ZAG水平明显降低,ZAG可能参与了DR的发生与发展。HbA1c、三酰甘油、HOMA-IR指数、体质指数可负性调节ZAG水平。更多还原

【Abstract】 Objective To investigate serum zinc-α2-glycoprotein(ZAG) level and its clinical significance in type 2 diabetes mellitus(T2 DM) patients with diabetic retinopathy(DR). Methods A total of 227 T2 DM patients were enrolled as research subjects, and they were divided into simple T2 DM group(T2 DM group, n=76), non-proliferative diabetic retinopathy(NPDR) group(NPDR group, n=82) and proliferative diabetic retinopathy(PDR) group(PDR group, n=69) according to the DR stage. Concurrently, another 70 healthy check-up individuals were enrolled as control group. Clinical indicators, ZAG level, glycolipid metabolism and hepatic and renal function indicators were compared among the four groups, and the correlation of ZAG level with clinical indicators as well as its influencing factors was analyzed in DR patients. Results ZAG level decreased successively and FBG, hemoglobin A1 c(HbA1 c) and homeostasis model assessment for insulin resistance(HOMA-IR) index increased successively in the control group, the T2 DM group, the NPDR group and the PDR group(all P<0.05). Serum ZAG level negatively correlated with diabetes duration,SBP, body mass index, TC, TG, FBG,HbA1 c, fasting insulin, and HOMA-IR index(all P<0.05). HbA1 c, TG, HOMA-IR index, and body mass index were the independent influencing factors of ZAG level(all P<0.05). Conclusion DR patients experience notably decreased ZAG level, ZAG might be involved in the onset and progression of DR. HbA1 c, TG, HOMA-IR index, and body mass index can regulate ZAG level negatively.更多还原