Correlation Between Blood Glucose Fluctuation,Serum 1,5-AG、LMP-10 And Diabetic Retinopathy In T2DM Patients

Objective:This study aimed to observe the association between retinopathy and short-term blood glucose fluctuations,serum 1,5-anhydroglucitol(1,5-AG)in patients with type 2 diabetes with no retinopathy.Methods: 255 patients with type 2 diabetes were selected from the Endocrinology Department of Hebei Provincial People’s Hospital from March 2019 to December 2019.According to the presence of retinopathy,they were divided into retinopathy group(DR group)and ignoring omentosis group(NDR group).Fully inform the patient and obtain the consent,sign the informed consent,the next morning to leave the patient fasting blood samples,and record each subject’s name,sex,age and other data,determine the patient’s lipid metabolism,thyroid function,renal function,liver function and other indicators;the glycosylated hemoglobin(Hb A1c),seven-point blood glucose were recorded and the blood glucose variation was calculated;the serum LMP-10、1,5-AG level was measured;the fundus was examined by fundus photography and fundus examination,and the vascular diameter was measured by computer software.The data application spss25.0 statistical software for data analysis,p<0.05 as the result is meaningful.Results:1.Comparison of the indexes between diabetic retinopathy group and diabetic retinopathy group1.1Comparison of general indexes between two groups There were statistically significant differences in the course of diabetes,the presence of diabetic peripheral neuropathy,blood urea nitrogen(BUN),urinary protein,urinary microalbumin,and total cholesterol(TC)between the two groups(P < 0.05).However,no statistically significant difference were there in age,body mass index(BMI),serum albumin(propagated),albumin,γ-pancreatic acyltransferase(γ-GT),Uric acid,Uric creatinine,glomerular filtration rate(Cr),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),thyroid stimulating element(TSH),total thyroid hormone(TT4),total three iodine thyroid original glycine(TT3)between the two groups(P > 0.05).1.2Comparison of glucose metabolism indexes between two groups There were significant differences in Hb A1 c,HOMA-IR,MBG and CV between the two groups(P < 0.05),but no significant differences in FBG,SDBG,PPGE(P > 0.05).1.3Comparison of serum 1,5-AG and LMP-10 levels between the two groups The serum level of 1,5-ag in diabetic retinopathy group was lower than that in non-diabetic retinopathy group,and the serum lmp-10 level was higher than that in non-diabetic retinopathy group.The difference was statistically significant(P < 0.05).2.Risk factors analysis of diabetic retinopathy and blood glucose fluctuation,1,5-AG,LMP-10 in T2 DM patients The single factor analysis(P < 0.05)was introduced into logistic regression model.In T2 DM patients,whether they have diabetic retinopathy or not as the dependent variable,the course of diabetes,total cholesterol,whether there is neuropathy,24-hour urinary microalbumin,1,5-AG,LMP-10 as the independent variables.Logistic regression analysis shows that the total cholesterol(OR=1.071,P=0.003),1,5-AG(OR= 0.951,P < 0.001)was the protective factor of diabetic retinopathy,while the long course of diabetes(OR=1.071,P =0.003),with diabetic peripheral neuropathy(OR=2.741,P=0.01),24-hour urinary microalbumin(OR =1.005,P < 0.001),LMP-10(OR= 1.039,P < 0.001)were the risk factors of diabetic retinopathy.3.Correlation analysis of blood glucose fluctuation,serum 1,5-AG,lmp-10 and AVR In T2 DM patients,serum 1,5-AG had significant positive correlation with AVR(r=0.357,P<0.001),while LMP-10(r=-0.148,P< 0.05)and PPGE(r=-0.135,P< 0.05)had no significant correlation with AVR.In T2 DM patients,the decrease of AVR was taken as the dependent variable,and the levels of serum 1,5-AG,LMP-10 and PPGE were taken as the independent variables.Through multiple regression analysis,it was found that the increase of serum 1,5-AG in T2 DM patients was the protective factor of AVR,while the increase of LMP-10(P < 0.05)and PPGE(P = 0.039)were the risk factors of AVR decrease.Conclusion:1.Serum 1,5-AG level in the diabetic retinopathy group was significantly lower than that in the non-diabetic retinopathy group,and the LMP-10 level was significantly higher than that in the normal group.serum1,5-AG levels were significantly positively correlated with arteriovenous width ratio in type 2 diabetic patients.2.The fluctuation of blood glucose,the decrease of 1,5-AG and the increase of LMP-10 were independent risk factors for diabetic retinopathy;the increase of serum 1,5-AG was a protective factor for T2 DM patients,and the increase of serum LMP-10 and PPGE were independent risk factors for the decrease.