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糖尿病视网膜病变患者的代谢特征及影响因素OA

Metabolic characteristics and related influencing factors in patients with diabetic retinopathy

中文摘要英文摘要

目的 探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者的代谢特征及相关影响因素.方法 回顾性分析 2020年 1月至 2024年 9月在南京中医药大学附属医院住院治疗的 467例糖尿病患者的临床资料,分为 DR组(n=150)和非 DR组(n=317).采用肝脏瞬时弹性检测仪检测患者肝脏硬度值(liver stiffness measurement,LSM)和受控衰减参数(controlled attenuation parameter,CAP),并将其分为 5级.比较两组患者基本资料,LSM、CAP分级,以及代谢指标.采用单因素和多因素 logistic回归分析 DR的影响因素.结果 DR组患者的年龄大于非 DR组(P<0.001);空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycated hemoglobin A1C,HbA1C)、三酰甘油(triglyceride,TG)水平高于非 DR组,低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)低于非 DR组(P<0.05).LSM分级在两组间差异有统计学意义(P=0.006).多因素 logistic回归结果显示,LSM分级(2级:OR=2.127,P=0.002;3级:OR=2.344,P=0.030;4级:OR=2.960,P=0.038)、FBG(OR=1.233,P<0.001)、血清肌酐(OR=1.013,P=0.006)等为 DR的独立相关因素.结论 FBG、血清肌酐、LSM是 DR的相关因素,在临床实践中应关注血糖控制、肾功能监测及肝纤维化评估的协同管理,早期干预以降低DR发生风险.

Objective To explore the metabolic characteristics and related factors in patients with diabetic retinopathy(DR).Methods A retrospective study was conducted on the clinical data of 467 diabetic patients hospitalized at the Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to September 2024.The patients were divided into the DR group(n=150)and the non-DR group(n=317).Liver stiffness measurement(LSM)and controlled attenuation parameter(CAP)were assessed using a transient elastography device,and graded into five levels.Basic data,LSM and CAP grading,and metabolic indicators were compared between the two groups.Univariate and multivariate logistic regression analyses were applied to identify factors influencing DR.Results Patients in the DR group were older than those in the non-DR group(P<0.001).Compared with the non-DR group,fasting blood glucose(FBG),glycated hemoglobin A1C(HbA1C),and triglyceride(TG)levels were higher,while low-density lipoprotein cholesterol(LDL-C)was lower in the DR group(P<0.05).Significant differences in LSM grading were observed between the two groups(P=0.006).Multivariate logistic regression analysis revealed that LSM grading(grade 2:OR=2.127,P=0.002;grade 3:OR=2.344,P=0.030;grade 4:OR=2.960,P=0.038),FBG(OR=1.233,P<0.001),and serum creatinine(OR=1.013,P=0.006)were independent factors associated with DR.Conclusions FBG,serum creatinine,and LSM are related factors of DR.In clinical practice,attention should be paid to the coordinated management of blood glucose control,renal function monitoring,and liver fibrosis assessment,with early interventions to reduce the risk of DR.

刘思漫;孙心怡;葛静;余旭;缪鋆鋆

南京中医药大学附属医院内分泌科,南京 210029南京中医药大学附属医院内分泌科,南京 210029南京中医药大学附属医院内分泌科,南京 210029南京中医药大学附属医院内分泌科,南京 210029南京中医药大学附属医院内分泌科,南京 210029

医药卫生

糖尿病糖尿病视网膜病变代谢特征影响因素

diabetes mellitusdiabetic retinopathymetabolic characteristicinfluencing factor

《中国临床医学》 2026 (4)

636-642,7

江苏省中医药管理局项目(MS2021009).Supported by Project of Jiangsu Provincial Administration of Traditional Chinese Medicine(MS2021009).

10.12025/j.issn.1008-6358.2026.20260399

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