房水HMGB-1、FABP-4对糖尿病性白内障患者PHACO后发生黄斑水肿的诊断价值OA

Objective To investigate the diagnostic value of aqueous humor high mobility group protein B-1(HMGB-1)and fatty acid binding protein-4(FABP-4)levels for macular edema(ME)after phacoemulsifi-cation(PHACO)for diabetic cataract(DC)patients.Methods A total of 81 DC patients who developed ME after receiving PHACO in 3201 Hospital from January 2022 to December 2024 were selected as the ME group and divided into mild ME group,moderate ME group and severe ME group according to the severity of ME.Another 81 DC patients who did not develop ME after receiving PHACO in 3201 Hospital during the same pe-riod were selected as the non-ME group.Baseline data of all subjects were collected.The levels of HMGB-1 and FABP-4 in the aqueous humor of all subjects were detected.Spearman correlation was used to analyze the correlation between the levels of HMGB-1 and FABP-4 in the aqueous humor of DC complicated with ME and the severity of ME.Multivariate Logistic regression was used to analyze the influencing factors of ME in DC patients after PHACO.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of HMGB-1,FABP-4 alone and combined detection of aqueous humor for ME after PHACO in DC pa-tients.Results The duration of type 2 diabetes mellitus(T2DM)in the ME group was longer than that in the non-ME group,the proportion of patients with DR,the level of glycosylated hemoglobin,the level of low-den-sity lipoprotein cholesterol,and the levels of HMGB-1 and FABP-4 in the aqueous humor were higher than those in the non-ME group,and the differences were statistically significant(P<0.05).There were 40 pa-tients in the mild ME group,29 patients in the moderate ME group,and 12 patients in the severe ME group.The levels of HMGB-1 and FABP-4 in the mild ME group,moderate ME group and severe ME group in-creased in turn,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that the levels of HMGB-1 and FABP-4 in the aqueous humor of DC complicated with ME were posi-tively correlated with the severity of ME(rs=0.832,0.808,P<0.001).Multivariate Logistic regression anal-ysis showed that prolonged duration of T2DM,complicated with DR,increased HMGB-1 level and increased FABP-4 level were independent risk factors for ME in DC patients after PHACO(P<0.05).ROC curve anal-ysis showed that the area under the curve(AUC)of aqueous humor HMGB-1 and FABP-4 combined to diag-nostic ME after PHACO in DC patients was 0.891,which was larger than the AUC of aqueous humor HMGB-1 and FABP-4 alone(Z=2.581,3.321,P<0.05).Conclusion The increased levels of HMGB-1 and FABP-4 in aqueous humor are related to the occurrence of ME and the aggravation of the severity of ME in DC patients after PHACO.The combined detection of HMGB-1 and FABP-4 in aqueous humor has a high diag-nostic value for the occurrence of ME in DC patients after PHACO.