Study On The Correlation Of Adiponectin And Leptin With Diabetic Retinopathy

Objective: in our country, the incidence rate of type 2 diabetes mellitus(T2DM) and its related complications was increasing year by year. In those related complications, the diabeticretinopathy(DR) was one of the most common severe complications of microvasculatures, and also was one of the four major blind leading hereditary diseases. But the generation mechanism of DR has not been fully elucidated. In fact, the incidence of DR and the severity are closely related to the course of T2DM, Fasting blood glucose(FBG), hemoglobin A1c(HbA1c) and Total Cholesterol(TC). In recent years, some studies show that adiponectin(APN) and leptin(LP) play a very important role on the occurrence and development of DR. For this reason, in our work, we try to measure the APN and LP levels in serum of the patients with T2DM then we discusse the change regularity of APN and LP levels in serum at different stages and its role in occurrence and development of DR.Methods: 1. the test group consisted of 90 patients(47 males, 43 females) to whom had been diagnosed with T2DM in endocrine department and ophthalmology department of the Second Affiliated Hospital of Dalian Medical University from 2010.3 -2010.12[The diagnostic criteria of DM based on the WHO diagnostic criteria which was formulated in 1999. DR Group based on the 2002 International latest staging of diabetic retinopathy and among them], Based on the degree of DR was classified into following categories:①non-DR (NDR) group, that is gradeⅠ, 30 patients (14 males, 16 females).②nonproliferative-DR (NPDR) group, named as gradeⅡ-Ⅳ, 30 patients (17 male and 13 female).③proliferative-DR (PDR) group, namely gradeⅤ, and 30 patients (16 males and 14 females).2. the control group was 30 cataract patients(17 males and 13 females) . selected for the same period in Ophthalmology department of our hospital, whose blood sugar and urine sugar are normal. 3. All selected patients have no liver and kidney dysfunction, cardiovascular disease and metabolic diseases. 6ml blood samples were received from median cubital vein non-fasting in morning, which 4ml of the samples were sent to detect FBG, HbA1c and TC level, 2ml of the samples used to detect level of serum APN and LP. The height, weight were measured, and we calculated mass index (BMI).Results: 1. In NDR, NPDR and PDR groups, the level of serum LP, FBG, HbA1c and BMI were higher than that in control group, but the level of APN was lower than that in control group(P <0.05), the difference had statistical sense. The level 0f TC in NPDR and PDR groups were higher than that in control group(P< 0.05), the difference had statistical sense. The level 0f TC had no statistical difference between NDR group and the control group(P> 0.05), the difference had no statistical sense.2. In the NPDR and PDR groups, duration of T2DM, the level of serum LP, FBG, HbA1c, and BMI were higher than that in NDR group, but the level of APN was lower than that in NDR group(P <0.05), the difference had statistical sense. The level of TC in PDR group was higher than that in NDR group(P<0.05), the difference had statistical sense. The level of TC had no statistical difference between the NPDR group and NDR group(P>0.05), the difference had no statistical sense.3. In PDR group, duration of T2DM, the level of serum LP, FBG, HbA1c, TC and BMI were higher than that in NPDR group, the level of serum APN was lower than that in NPDR group(P<0.05), the difference had statistical sense.4. The severity of DR positively correlated with duration of T2DM, LP, FBG, HbA1c, TC and BMI (r=0.741, 0.305, 0.428, 0.256, 0.491, P<0.01); The severity of DR negatively correlated with serum APN levels(r=-0.512, P<0.01).5. The level of Serum APN negatively correlated with T2DM duration, FBG, HbA1c, TC and BMI (r=-0.692, -0.291, -0.411, -0.217, -0.612, P<0.01), The level of Serum LP positively correlated with T2DM duration, FBG, HbA1c and BMI (r=0.627, 0.271, 0.366, 0.725, P<0.01), the level of serum APN and LP was negative correlation (r=-0.509, P<0.01).Conclusions: 1.The longer course of T2DM, the higher FBG, HbA1c, TC and BMI, the more severe DR. 2.Serum APN levels of T2DM patients was obvious reduction, which correlated with DR negatively; serum LP levels was obvious increased, which correlated with DR positively; serum APN and LP may be involved in the occurrence and development of DM and DR .