Correlation Between Retinol Binding Protein 4 And Cystatin C And Diabetic Retinopathy In Elderly Patients With Type 2 Diabetes

Objective To investigate the correlation between the serum Retinol binding protein4(RBP4),cystatin C(Cys C)and the severity of type 2 diabetes mellitus complicated with retinopathy in the elderly.This is the theoretical evidence for the early prevention of diabetic retinopathy.Methods A total of 92 patients with diabetes who met the inclusion criteria and exclusion criteria were collected in the department of endocrinology of baosteel hospital in Inner Mongolia from December 2016 to June 2018.Professional ophthalmologists completed the fundus examination and recorded the results.According to the results of fundus examination,they were divided into 3 groups: non-diabetic retinopathy group(NDR),background diabetic retinopathy group(BDR),proliferative diabetic retinopathy group(PDR).Besides,there is a control group including 30 healthy individuals.Record the information of each person include the age,gender,Systolic blood pressure(SBP),Diasstolic blood pressure(DBP),Boby Mass Index(BMI),the course of diabetes,fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1c),triglyceride(TG),cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and other laboratory tests.The levels of serum RBP4 and Cys C were measured by ELISA,and the data were analyzed statistically.Result 1.The age and sex showed no statistical differences between the group(P>0.05),which guarantees the validity of comparison among groups.There was no significant difference in systolic and diastolic blood pressure among the four groups(P>0.05).The BMI in NDR,BDR,PDR group was statistically significantly higher than that in CON group(P<0.05).However,there was no significant difference in BMI in pairwise T2 DM among the three groups(P>0.05).The course of disease are statistically significantly different among the3 groups of patients(P <0.05).2.Compared with CON group,the TG,TC and LDL of NDR,BDR and PDR were statistically increased(P <0.05),the HDL was statistically decreased(P<0.05).The Cr in NDR,BDR,PDR group was statistically higher than that in CON group(P <0.05),the Cr in BDR,PDR group was statistically higher than that in NDR group(P < 0.05).However,the difference between BDR and PDR was not statistically significant(P > 0.05).The FPG,Hb A1 C of NDR,BDR,PDR group was higher than that in CON group.With the development of NDR,BDR,PDR in T2 DM group,the FPG increased gradually,the results were statistically significant(P <0.05).However,there was no significant difference in Hb A1 C in pairwise T2 DM among the three groups(P>0.05).The 25-OH-VD in NDR,BDR,PDR group was lower than that in CON group.With the progress of NDR,BDR,PDR in T2 DM group,the level of 25-OH-VD decreased gradually.The results were statistically significant(P < 0.05).3.RBP4 and Cys C were statistically significant between CON,NDR,BDR,PDR group(P<0.05).4.Using RBP4 as dependent variable,the correlation analysis shows that RBP4 is positively correlated(P<0.05)with course of disease,BMI,FPG,Hb A1 C,TC,TG,LDL-C,Cr and Cys C,negatively correlated with HDL-C and 25-OH-VD(P <0.05)and not significantly correlated with gender,age,SBP,DBP(P >0.05).Similarly,using Cys C as dependent variable,Cys C is positively correlated(P <0.05)with course of disease,BMI,FPG,Hb A1 C,TC,TG,LDL-C,Cr and RBP4,negatively correlated with HDL-C and25-OH-VD(P<0.05)and not significantly correlated with gender,age,SBP,DBP(P >0.05).5.Using the occurrence of diabetic retinopathy as dependent variable,course of disease,BMI,FPG,Hb A1 C,TC,TG,LDL-C,HDL-C,Cr,25-OH-VD,RBP4 and Cys C as independent variables,the logit regression results show RBP4,Cys C,FPG and course of disease may be an important risk factors of diabetic retinopathy,25-OH-VD may be a protective factor of diabetic retinopathy.Conclusion 1.RBP4,Cys-C increased gradually during the progression of type 2 diabetes mellitus complicated with retinopathy,which could reflect the severity of diabetic retinopathy.2.RBP4,Cys C may be an important risk factor for diabetic retinopathy,and the change of its level may play an early role in predicting diabetic retinopathy.