The Relationship Between Serum Lipid, Insulin Resistance And Diabetic Retinopathy In Type 2 Diabetes Mellitus

Objective:to observe the relationship between serum lipid,insulin resistance and diabetic retinopathy in type 2 diabetes mellitus.Methods:1.Study object:49 diagnosed type 2 diabetes mellitus cases,according to 1999 WHO diabetes mellitus criteria,were enrolled.They were screened in Department of Endocrinology, the Second Hospital of Shanxi Medical University from July in 2007 to January 2008.There were 23 patients were men and 26 women,years of age from forty to eighty-nine.To remove patients who have abnormal state as follows:①accurate metabolism disorder:like diabetes ketoacidosis,hyperosmolar nonketotic diabetic coma,②liver or kidney abnormal,③essential hypertension or secondary hypertension,④eye diseases affecting fundus observation,⑤serious heart failure and cancer and so on.2.Group:All cases were devided into non-diabetic retinopathy,background diabetic retinopathy and proliferative diabetic retinopathy three groups according to if have diabetic retinopathy and the serious degree of diabetic retinopathy in type 2 diabetic mellitus.3.Study methods:retrospectively analyze 49 patients with type 2 diabetes mellitus who were divided into non-diabetic retinopathy,background diabetic retinopathy and proliferative diabetic retinopathy.Collection patients first chemical examination index after hospital admission.Collect venous blood in early morning after fasting twelve hours.Their fasting plasma glucose,true insulin,glycosylated hemoglobin Alc,triglyceride,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoproteins a, apolipoproteins b were collected.And their insulin sensitivity index were calculated.All patients were carried out examination of ocular fundus(according to interview protocol of ophthalmologist).Results:1.to make use of Kruskal-Wallis rank-sum test,FBG,TI,HbAlc,ISI,TG,LDL,APOA were significantly different among the three groups,(P=0.012,0.025,0.000,0.002,0.001,0.012,0.000).TC,HDL,APOB among the three groups were no statistically significant.2.Compared to NDR group,TG,LDL in BDR group were significantly higher(P＜0.05), the rest index were no statistically significant.3.Compared to NDR group,HbAlc,FBG,TI,TG,LDL-C in PDR group were significantly higher(P＜0.05),TG was very significantly higher(P＜0.01),APOA and ISI were significantly lower(P＜0.01).4.Compared to BDR group,HbAlc was significantly higher than PDR group(P＜0.01), ISI was significantly lower than PDR group(P＜0.01),the rest index were no statistically significant.5.Rank correlation analysis show diabetic retinopathy was significant correlate with TG, LDL-C,APOA,TI,ISI.Conclusion:1.Abnormal metabolism of serum lipid and diabetic retinopathy are positive correlated in type 2 diabetes mellitus.Rank correlation analysis show diabetic retinopathy was significant correlate with TG,LDL-C.Dislipidemia may prompt the development and progression of diabetic retinopathy.2.ISI was no statistically significant between BDR group and NDR group,but compared to PDR group,ISI was significantly higher in BDR group and NDR group.Rank correlation analysis show diabetic retinopathy was significant correlate with TI,ISI.Insulin resistance may prompt the development and progression of diabetic retinopathy.