The Study About The Relationship Between Estrogen And Diabetic Retinopathy Of The Postmenopasual Patients With T2DM

BackgroundsIn the recent years, diabetes (diabetes mellitus, DM) as a kind of endocrinal and metabolic disease are rapidly increased in not only the developed but the developing countries.Research shows the major factor is not diabetes itself but the mutiple chronic complications of diabetes, which influences the prognosis and the quality of the life of the patients with diabetes. Diabetic retinopathy (DR),as one of the most common and severe diabetic microvascular complications, is one of the major blinding diseases of labor groups in most countries and regions around the world and brings enormous economic and social burden to mankind. Therefore,it has become an important research topic to explore the patho genesis of DR and discover the new and effective control and protective measures.Estrogen,as a steroidal sexual hormone, plays a wide range of biological effects in the body. Domestic and foreign research datas show that there are close relationships between estrogen and the development and progression of diabetes and its complications. Objective In the experiment,67 clinical cases postmenopausal with T2DM are analysed to learn more about the appropriate relationship between estrogen and diabetic retinopathy, and provide certain clinical clues and the theoretical supports for the clinical treatment of diabetic retinopathy.Datas and Methods67 cases of postmenopausal women with T2DM were collected from the department of endocrinology and metabolism of the second clinical college of Zhengzhou university. They were diagnosed with diabetes mellitus based on the criteria of Expert Committee on the Diagnosis and Classification of Diabetes World Health Organization,1999. The diagnostic criterea for DR is according to the stage of diabetic retinopathy discussed and implemented in the third national conference of the Chinese Medical Association Ophthalmology,1984.And all patients were divided into diabetic retinopathy group and nondiabetic retinopathy group. They were without taking sex hormones who were during more than one year after menopause.The patients were excluded from the clinical cases who had primary heart diaseses,liver diseases,renal diseases,acute diabetic complications such as urinary tract infection,DKA,etc and the other endocrinal diseases.In general all patients were recorded including name, age,duration of diabetes and the period of menopause etc. All patients received the fundoscopy and at the same time the record including the level of glucose,HBA1C,blood lipids,sex hormones were collected.Results1 Comporasions of differences Of the diabetic retinopathy group, average duration of diabetes and the level of fasting blood glucose as well as the HBA1C was obviously higher than that of nondiabetic retinopathygroup(F<0.05).The degree of age,the period of menopause between the diabetic retinopathy group and the nondiabetic retinopathy group was not significant.2 Comporasions of blood fat TC,TG and LDL-c of the diabetic retinopathy group were higher than that of nondiabetic retinopathy group(P<0.05 and P< 0.01),while the level of HDL-c of the diabetic retinopathy group was less than that of the nondiabetic retinopathy group(P<0.05). 3 Compasions of sex hormones The level of estrogen(E2) of the diabetic retinopathy group was lower than that of the nondiabetic retinopathy group(P< 0.05).While there was not a significant difference of the level of testosteron (T),follicle stimulating hormone (FSH) and luteining hormone (LH) between the two group.4 Mutiple logistic regression analysis showed that duration of diabetes, LDL-C,TC,TG and fasting blood glucose were maybe risk factors to the diabetic retinopathy but estrogen and HDL-C were protective factors.Conclusions1.Diabetic retinopathy is related with the duration of diabetes,fasting blood glucose and blood lipids.A appropriate controll of fasting blood glucose and blood lipids could delay the development and progression of the diabetic retinopathy.2. Low level of estrogen in the postmenopausal women of T2DM with diabetic retinopathy shows that estrogen may be one of the protective factors to the diabetic retinopathy.