Changes And Significance Of Serum ANGPTL6 And Leptin Levels In Patients With Type 2 Diabetic Retinopathy

Objective:To observe the changes in serum levels of angiopoietin-like protein 6(ANGPTL6)and Leptin in patients with type 2 diabetes mellitus(T2DM),and preliminarily analyze the correlation between ANGPTL6,Leptin and diabetic retinopathy(DR).Method:113 patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the Department of Endocrinology,Second Hospital of Shanxi Medical University from October 2019 to December 2020 were selected as the research objects.According to the results of examination,they were divided into Non-DR group(40 cases),NPDR group(45cases)and PDR group(28 cases),at the same time 50 case in the physical examination center were randomly selected as control group(NC).General data and clinical indexes of all subjects were collected,and serum ANGPTL6 and Leptin levels were detected by ELISA.Pearson correlation analysis was used to analyze the correlation between ANGPTL6 and Leptin and other indicators,and the independent risk influencing factors of DR was analyzed by binary logistic regression analysis method.Receiver operating characteristic curve(ROC)was used to analyze the clinical diagnostic value of ANGPTL6 and Leptin in dr.P < 0.05 is statistically significant.Results:1.Compared with NC group,Non-DR group and NPDR group,ANGPTL6(F=20.11,P < 0.05)and Leptin(F=24.66,P < 0.05)in PDR group increased markedly.Compared with NC group and Non-DR group,ANGPTL6(F=20.11,P < 0.05)and Leptin(F=24.66,P < 0.05)in NPDR group increased significantly.2.Pearson correlation analysis showed that ANGPTL6 was positively correlated with Leptin,Age,BMI,FPG and Hb A1 c in all DR patients(r = 0.336,0.420,0.358,0.480,0.382,all P < 0.05),but not with other indexes(all P > 0.05)Leptin was positively correlated with ANGPTL6,Age,BMI and HOMA-IR(r = 0.336,0.478,0.413,0.453,P <0.05,respectively),but had no obvious correlation with other indexes(P > 0.05).3.Binary Logistic regression analysis results showed ANGPTL6,Leptin,Hb A1 c and SBP were independent risk factors for T2 DM complicated with DR(P < 0.05).4.The best critical value of ANGPTL6 is 16.48,and the sensitivity and specificity of diagnosing PDR are 82.14% and 80%.The area under ROC curve was 0.849,95% CI:0.759 ～ 0.938,P <0.0001.The best critical value of Leptin is 2.904,and the sensitivity and specificity of diagnosing PDR are 46.43% and 97.06%.The area under ROC curve was 0.747,95% CI: 0.619 ～ 0.875,P=0.0009.The area under ROC curve was 0.984,95%CI: 0.823 ～ 0.966,P <0.0001.Conclusion:1.The levels of serum ANGPTL6 and Leptin in patients with type 2 diabetic retinopathy increased,and the levels of serum ANGPTL6 and Leptin in PDR patients were higher than those in NPDR patients.2.ANGPTL6 and Leptin are the risk factors of DR,and their elevated levels may be involved in the occurrence and development of DR.