The Correlation Between Estrogen And Diabetic Retinopathy Of The Postmenopasual Patients

Objective To observe the correlation between postmenopausal estrogen levels and diabetic retinopathy(DR)in women.Methods Thirty-nine female patients with type 2 diabetes mellitus and 17 normal menopause subjects(control group)were enrolled in this study.Normal subjects aged from 53 to 82 years,with the mean age of(69.80±8.32)years.Diabetes mellitus patients aged from 56 to 84 years,with the mean age of(70.50±8.27)years;diabetes course ranged from 3 to 23 years,with the average course of diabetes(11.40±7.97)years.According to the results of fundus fluorescein angiography,DR diagnosis was established,and the patients were divided into 19 patients of DR group and 20 patients without DR group(NDR group).There was no significant difference in age and menopause between the three groups(t=0.347,0.485;P>0.05).There was significant difference in diabetes course(t=2.748,P<0.05).Compared with NDR group,fasting glucose(FBG),glycosylated hemoglobin(HbAlc),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C)were significantly increased(t=6.130,5.322,4.574,2.426,4.033),high density lipoprotein cholesterol(HDL-C)was significantly lower(t=3.917),the difference was statistically significant(P<0.05).The level of estradiol(E2)was measured by radioimmunoassay.The differences in E2 levels between the three groups were compared.Logistic regression analysis was used to analyze the influencing factors of DR.Results The levels of E2 in control group,DR group and NDR group were(42.38±8.64),(21.49±9.81)and(32.72±10.51)pg/ml,respectively.The level of E2 in DR group was significantly lower than that in NDR group and control group(t=3.443,10.11;P<0.05).Logistic regression analysis showed that the duration of diabetes mellitus[regression coefficient =0.166,odds ratio(OR)=1.181,P=0.016],FBG(regression coefficient=1.162,OR=4.014,P=0.001),TC(regression coefficient=3.212,OR=10.820,P=0.002),TG(regression coefficient=1.649,OR=5.203,P= 0.030)and LDL-C(regression coefficient=1.605,OR= 4.976,P=0.003)were the risk factors for DR;E2(Regression coefficient=-0.100,OR=0.904,P=0.004)and HDL-C(regression coefficient =-4.460,OR=0.012,P=0.002)were the protective factors for DR.Conclusion The estrogen level of postmenopausal women have a certain correlation with the development of DR,it may be one of the protective factor of DR.