The Study Of The Relationship Between Estradiol And Testosterone Levels And The Occurrence Of Diabetic Retinopathy

Objection:Estradiol and testosterone are steroid hormones produced and secreted by the gonads,which play a very important role in the human body.there is a great difference and fluctuation in the endocrine levels of different sex and different age groups,which is closely related to some sex tendency diseases.A large number of studies have also found that the presence of the corresponding hormone receptors in retinal cells is associated with diabetic retinopathy.The purposes of our study was to investigate the relationship between serum estradiol and testosterone levels and the occurence of diabetic retinopathy by detecting serum estradiol and testosterone concentration in patients with or without diabetic retinopathy.Methods:We collected 141 middle-aged and elderly patients with type 2 diabetes mellitus in the Department of Ophthalmology and Department of Endocrinology in our hospital.They are divided into non-diabetic retinopathy group?NDR?and diabetic retinopathy group?DR?according to the dilated-pupil retinal examination,retinal photography and fundus fluorescence angiography?FFA?,and then divided into male diabetic retinopathy group?mDR,n=32?,male non-diabetic retinopathy group?mNDR,n=15?and female diabetic retinopathy group?fDR,n=25?and female non-diabetic retinopathy group?fNDR,n=13?according to different genders.At the same time,56 healthy people?female menopause for more than 1 years?were selected as the control group,according to gender difference,they were divided into male control group?mND,n=26?and female control group?fND,n=30?,with 32cases in each group.All patients were excluded from taking sex hormone drugs and drugs that affect the level of sex hormones,primary heart,liver,kidney diseases,diseases related to gonadal dysfunction and acute complications of diabetes such as diabetic ketoacidosis.The basic information of the subjects was recorded in detail:gender,age,blood pressure,weight,height,duration of diabetes,fasting blood glucose?FBG?and glycosylated hemoglobin?HbA1c?.Serum estradiol and testosterone levels were measured by Enzyme-linked immunosorbent assay technology?ELISA?.Results:1.The course of diabetes in male and female DR group is significantly higher than that in NDR group,the difference is statistically significant?P<0.05?,the fasting blood glucose and glycosylated hemoglobin levels between the three groups are DR>NDR>ND,the difference is statistically significant?P<0.01?.The results of comparision between two groups:fasting blood glucose and glycosylated hemoglobin in ND are significantly lower than those in NDR and DR?P<0.01?and NDR is significantly lower than DR?P<0.05?.There is no significant difference in age,body mass index?BMI?and female menopause years between DR,NDR and ND?P>0.05?.2.Serum estradiol concentration:There is significant difference in serum estradiol concentrationbetweenthreegroupsofmDR,mNDRand mND,mDR>mNDR>mND?P<0.01?,there are also differences in the female group:fNDR>fND>fDR,?P<0.05?.The results of comparision between two groups:mDR estradiol is higher than mNDR,the difference is statistically significant?P<0.05?,mDR is higher than mND,the difference is statistically significant?P<0.01?,mNDR is higher than mND,the difference is statistically significant?P<0.05?,there are no statistical difference between fND and fNDR and fDR?P>0.05?;fNDR is higher than fDR,the difference is statistically significant?P<0.05?.Serum testosterone concentration:there are no statistically significant difference between the three groups?P<0.05?.There are significant differences between the three groups of serum testosterone in women,,fDR>fNDR>fND?P<0.01?.The results of comparision between two groups:fDR is higher than fND,the difference is statistically significant?P<0.01?;fNDR is higher than fND,the difference is statistically significant?P<0.05?;There is no statistical difference between fNDR and fND?P>0.05?.3.E₂/T:comparison between three groups:there is significant difference in E₂/T between mDR,mNDR and mND?mDR>mND>mNDR,P<0.05?,there is significant difference in E₂/T between fND,fNDR and fDR?fND>fNDR>fDR,P<0.01?.The results of comparision between two groups:mDR is higher than mNDR,the difference is statistically significant?P<0.05?,mDR is higher than mND,the difference is statistically significant?P<0.05?,there is no statistical difference between mNDR and mND?P>0.05?,fND is higher than fDR,the difference is statistically significant?P<0.01?,fNDR is higher than fDR,the difference is statistically significant?P<0.05?,there is no statistical difference between f ND and fNDR?P>0.05?.4.Logistic regression analysis of DR related factors:Multivariate logistic regression analysis shows that the duration of diabetes,fasting blood glucose and glycosylated hemoglobin are risk factors of diabetic retinopathy,estradiol and E₂/T are protective factors for DR in women.For men,estradiol and E₂/T are risk factors.Conclusion:1.Male diabetic patients with high estradiol levels are more likely to develop diabetic retinopathy.2.Low estradiol levels in female diabetic patients are more likely to develop diabetic retinopathy.3.E₂/T imbalance in the blood may have an impact on DR,compared with single hormone?E₂ or T?,E₂/T may be expected to be a more sensitive marker for predicting DR.