| Objective: To analyze the correlation between glycation gap(GG)and type 2 diabetic retinopathy(T2DR)in patients with type 2 diabetes mellitus(T2DM),and to explore the relationship between GG and the risk of DR in patients with T2DM。Method: A total of 90 T2 DM patients,including 43 males and 47 females,admitted to the outpatient and inpatient departments of Endocrinology and ophthalmology of Huainan Chaoyang Hospital from September 2021 to April 2022 were selected for fundus photography using Smartscope EY4 non-mydriatic fundus camera(Finland Optomed).Then,the images of the non-dilatatory fundus camera were uploaded to a third-party film reading institution,and the same ophthalmologist performed film reading and diagnosis.Finally,according to the DR Clinical grading criteria,the patients were divided into 3 groups:(1)Simple T2 DM group: no obvious abnormalities in fundus examination,a total of 30 cases;(2)Proliferative diabetic retinopathy(PDR)group: neovascularization or intravitreal/intraretinal hemorrhage,a total of 30 cases;(3)In the non-proliferative diabetic retinopathy(NPDR)group,the lesion degree was between the simple T2 DM group and the PDR group,with a total of 30 cases.Glycosylated hemoglobin(Hb A1c),fructosamine(FA),blood glucose(FPG),muscle liver(CREA),albumin(ALB)and other biochemical indexes were tested in all the above patients.The datum conforming to normal distribution were analyzed by variance analysis,and the comparison of components in pairs was analyzed by LSD-t test.Kruskal-Wallis rank sum test was used for data inconsistent with normal distribution,and Mann-Whitney U test was used for pairwise comparison between groups.The risk factors of T2 DR were analyzed by Logistic regression.Correlation test of indicators was conducted by Pearson or Spearman analysis.The optimal threshold of GG for T2 DR patients was analyzed using receiver operating characteristic curve(ROC).In addition,the GG group was divided into 30 cases of low GG group(L-GG group),30 cases of medium GG group(M-GG group)and 30 cases of high GG group(H-GG group)by the method of the quantile.Then binary Logistic regression was used to analyze the multiple relationship between the M-GG group,H-GG group and L-GG group.Results: 1.Hb A1 c was positively correlated with FA(r=0.663,P < 0.05),and the regression equation of Hb A1 c and FA was as follows: predicted value of Hb A1c=4.5+0.014×FA,R2 =0.44.2.The level of ALB in T2 DM group was significantly higher than that in PDR group(P<0.05).The BUN level in T2 DM group was significantly lower than that in PDR group(P<0.05),and that in NPDR group was significantly lower than that in PDR group(P<0.05).3.The Hb A1 c level in T2 DM group was significantly lower than that in PDR group(P<0.05),and the Hb A1 c level in NPDR group was significantly lower than that in PDR group(P<0.05).The GG level in T2 DM group was significantly lower than that in NPDR and PDR groups(P<0.05),and the GG level in NPDR group was significantly lower than that in PDR group(P<0.05).4.T2 DR was negatively correlated with ALB(r=-0.293,P<0.05).T2 DR was positively correlated with GG,course of disease,BUN,Hb A1 c and WC(r=0.415,0.183,0.242,0.336,0.247,P<0.05).5.Logistic regression analysis showed that WC,Hb A1 c and GG were all risk factors for T2DR(P<0.05).6.ROC curve showed that the sensitivity and specificity of T2 DR patients were0.783 and 0.667 with GG-0.512 as the diagnostic threshold.7.Risk analysis suggested that the risk of DR In H-GG group was 7.50 times of that in L-GG group [95%CI(2.44,25.06),P<0.05],and the risk of DR In M-GG group was 4.93 times of that in L-GG group [95%CI(1.61,15.07),P<0.05].There was no significant difference between M-GG group and H-GG group(P>0.05).Conclusions: 1.GG level in T2 DM group was significantly lower than that in NPDR group and PDR group(P<0.05),and GG level in NPDR group was significantly lower than that in PDR group(P<0.05).T2 DR was positively correlated with GG,and GG was an independent risk factor for DR In T2 DM patients.2.GG has good predictive value for T2 DR.3.With the continuous increase of GG level,the risk of T2 DR is also increasing... |
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