血清甘油三酯葡萄糖指数、视黄醇结合蛋白及β2-微球蛋白联合检测对糖尿病视网膜病变的预测及筛查价值

Values of serum triglyceride-glucose index combined with retinol-binding protein and β2-microglobulin in prediction and screening of diabetic retinopathy

  • 摘要:
    目的 探讨血清甘油三酯葡萄糖(TyG)指数、视黄醇结合蛋白(RBP)及β2-微球蛋白(β2-MG)联合检测对早期糖尿病视网膜病变(DR)的预测及筛查价值。
    方法 选取在本院诊治的2型糖尿病患者167例为研究对象。根据眼底检查结果将167例患者分为不伴有糖尿病任何并发症组(NDR组)60例、非增殖期糖尿病视网膜病变组(NPDR组)55例、增殖期糖尿病视网膜病变组(PDR组)52例。另选取同期本院体检中心的健康体检者60例作为对照组(CON组)。检测4组血清TyG指数、RBP及β2-MG的表达水平; 采用受试者工作特征(ROC)曲线分析血清TyG指数、RBP、β2-MG单独及联合检测预测和筛查DR的价值。
    结果 4组TyG指数、RBP、β2-MG的表达水平两两比较, 差异均有统计学意义(P < 0.05)。在3组2型糖尿病患者中, Spearman相关性分析提示患者糖尿病病程、收缩压(SBP)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、TyG指数、RBP、β2-MG与DR呈正相关(P < 0.05), Logistic回归分析显示病程、TyG指数、RBP是DR发生的独立危险因素。ROC曲线分析显示TyG指数、RBP、β2-MG联合检测的曲线下面积(AUC)为0.757, 敏感度为63.6%, 特异度为80.0%。
    结论 TyG指数、RBP、β2-MG在2型糖尿病患者中随着DR的病情加重而逐渐升高, 3个指标联合检测预测早期DR的效能最佳。

     

    Abstract:
    Objective To investigate the values of serum triglyceride-glucose (TyG) index combined with retinol-binding protein (RBP) and β2-microglobulin (β2-MG) in prediction and screening of diabetic retinopathy (DR) in early stage.
    Methods A total of 167 patients with type 2 diabetes in the authors' hospital were selected as research objects. According to the results of fundus examination, the 167 patients were divided into group without complications of diabetes (NDR group, n=60), group with non-proliferative diabetic retinopathy (NPDR group, n=55) and group with proliferative diabetic retinopathy (PDR group, n=52). Another 60 healthy people from the physical examination center of the authors'hospital during the same period were selected as control group (CON group). Serum levels of TyG index, RBP and β2-MG were detected in the four groups; the receiver operating characteristic (ROC) curve was used to analyze the values of the serum TyG index, RBP and β2-MG alone and their combination in the prediction and screening of DR.
    Results There were significant between-group differences in expression levels of TyG index, RBP and β2-MG among the four groups (P < 0.05). In the three groups of patients with type 2 diabetes, the Spearman correlation analysis showed that the duration of diabetes, systolic blood pressure (SBP), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), triglyceride (TG), TyG index, RBP and β2-MG were positively correlated with DR (P < 0.05), and the Logistic regression analysis showed that course of the disease, TyG index and RBP were the independent risk factors for the occurrence of DR. ROC curve analysis showed that the area under the curve (AUC) of the combination of TyG index, RBP and β2-MG was 0.757, with the sensitivity of 63.6% and the specificity of 80.0%.
    Conclusion Levels of TyG index, RBP and β2-MG gradually increase with the aggravation of DR in patients with type 2 diabetes, and the efficiency of the combined detection of three indicators is the best in predicting early DR.

     

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