肠道菌群及血清sdLDL-C、LPS与糖尿病视网膜病变的相关性研究OA

Objective To explore the correlations between gut microbiota,serum small and dense low-density lipoprotein cholesterol(sdLDL-C),lipopolysaccharide(LPS),and diabetic retinopathy(DR).Methods A total of 102 patients with type 2 diabetes(T2DM)who attended the First People's Hospital of Kashgar from October 2021 to October 2023 were selected.According to the presence or absence of diabetic retinopathy,patients were divided into non-DR group(n=72)and DR group(n=30).General information,laboratory indices,intestinal flora,and serum levels of sdLDL-C and LPS were compared between the two groups.Multivariate Logistic regression analysis was conducted to identify risk factors for DR.Spearman's correlation analysis was used to analyze the rank correlation between intestinal flora,serum sdLDL-C,LPS and DR.Receiver operating characteristic curves(ROC)was used to evaluate the predictive performance of serum sdLDL-C and LPS levels for DR.Results Co-mpared with the non-DR group,the DR group exhibited significantly elevated Bacteroides abundance(31.28±7.70)(t=9.905,P＜0.05);significantly elevated serum sdLDL-C(1.51±0.37)mmol/L and LPS(117.45±9.39)pg/mL levels(t=4.422,25.160,P＜0.05);and significantly reduced Bifidobacterium and Prevotella abundance(t=19.886,11.883,P＜0.05).There were no significant differences in Lactobacillus,Plasmodicoccus,Enterococcus,Eubacterium rectale,Veillonella,Clostridium tenellum,and Roseburia species(P＞0.05).Univariate analysis showed that the duration of diabetes,systolic pressure(SBP),serum creatinine(SCr),fasting blood glucose(FPG),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),glycosylated hemoglobin(HbA1c),and history of hypertension in the DR group were significantly higher than those in the non-DR group(P＜0.05).Age,body mass index(BMI),gender,diastolic pressure(DBP),smoking history,drinking history,total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)showed no statistically significant difference(P＞0.05).Multivariate Logistic regression showed that the duration of diabetes,SCr,TG,HbA1c,sdLDL-C,LPS,and elevated Bacteroides were risk factors for DR(P＜0.05),while reduced Prevotella was a protective factor for DR(P＜0.05).Correlation analysis showed that Bacteroides abundance,sdLDL-C,and LPS levels were positively correlated with DR(P＜0.05);while Bifidobacterium and Prevotella abundance were negatively correlated with DR(P＜0.05).ROC curve showed that combination of sdLDL-C and LPS had an area under the curve(AUC)(95％CI:0.719～0.893),with a sensitivity of 86.72％and a specificity of 79.83％.Conclusion Patients with T2DM complicated by DR exhibit gut dysbiosis and abnormally elevated serum sdLDL-C and LPS levels.sdLDL-C,LPS,and elevated Bacteroides are risk factors for DR,while Prevotella is a protective factor.