论文部分内容阅读
目的探讨血清胆红素与2型糖尿病(T2DM)患者血糖水平及糖尿病视网膜病变的关系,为临床指导T2DM患者控制血糖和对早期发现糖尿病视网膜病提供科学依据。方法选取2014年1月至2015年12月在河南省焦作煤业(集团)有限责任公司中央医院内分泌科住院的286例T2DM患者为研究对象,将其进一步分为单纯T2DM组(T2DM组),糖尿病非增殖期视网膜病变组(NPDR组),糖尿病增殖期视网膜病变组(PDR组),另选取在该院门诊体检的65例健康体检者作为对照组。测量调查对象的收缩压(SBP)、舒张压(DBP)、身高、体重并计算体质指数(BMI);测定空腹血糖(FPG)、糖化血红蛋白(HbA_(1C))、血清总胆红素(TBIL)、直接胆红素(DBIL)和间接胆红素(IBIL)水平。用SPSS 18.0软件进行统计分析,计量资料多组间比较用方差分析,计数资料比较用χ~2检验,两变量相关分析用Pearson相关分析。结果 T2DM组、NPDR组、PDR组的FPG、HbA_(1C)较对照组明显升高,而TBIL、DBIL、IBIL较对照组明显降低,差异有统计学意义(P<0.05);与T2DM组比较,NPDR组、PDR组FPG、HbA_(1C)水平明显升高,TBIL、DBIL、IBIL明显降低,差异有统计学意义(P<0.05);与NPDR组比较,PDR组FPG、HbA_(1C)水平明显升高,TBIL、DBIL、IBIL明显降低,差异有统计学意义(P<0.05)。T2DM组胆红素与FPG、HbA_(1C)无明显线性关系,无统计学意义(P>0.05)。NPDR组及PDR组胆红素均与FPG、HbA_(1C)呈负相关,均有统计学意义(P<0.05)。结论 T2DM患者血清胆红素可反映其血糖控制水平,胆红素水平降低与糖尿病视网膜病变的发生、发展可能存在某种关系。
Objective To investigate the relationship between serum bilirubin and blood glucose levels and diabetic retinopathy in patients with type 2 diabetes mellitus (T2DM) and to provide a scientific basis for clinical management of T2DM patients with blood glucose control and early detection of diabetic retinopathy. Methods A total of 286 T2DM patients hospitalized in Department of Endocrinology, Central Hospital of Jiaozuo Coal (Group) Co., Ltd., Henan Province from January 2014 to December 2015 were selected as study subjects and further divided into T2DM group (T2DM group) Diabetic nonproliferative retinopathy (NPDR group), diabetic proliferative retinopathy (PDR group), and the other 65 outpatient physical examination in the hospital were selected as the control group. SBP, DBP, body weight and body mass index (BMI) were measured. The levels of fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1 C), total bilirubin ), Direct bilirubin (DBIL) and indirect bilirubin (IBIL) levels. SPSS 18.0 software was used for statistical analysis, measurement data were compared between groups by analysis of variance, count data were compared using χ ~ 2 test, two-variable correlation analysis using Pearson correlation analysis. Results The levels of FPG and HbA_ (1C) in T2DM group, NPDR group and PDR group were significantly higher than those in control group, while the levels of TBIL, DBIL and IBIL in control group were significantly lower than those in control group (P <0.05). Compared with T2DM group (P <0.05). Compared with NPDR group, the level of FPG and HbA_ (1C) in PDR group was significantly increased, the levels of FPG and HbA_ (1C) in NPR group and PDR group were significantly increased, TBIL, DBIL and IBIL were significantly decreased (P <0.05). The levels of TBIL, DBIL and IBIL were significantly lower than those of control group (P <0.05). There was no significant linear relationship between bilirubin and FPG and HbA_ (1C) in T2DM group (P> 0.05). The levels of bilirubin in NPDR group and PDR group were negatively correlated with FPG and HbA 1 (P <0.05). Conclusion Serum bilirubin in T2DM patients can reflect the level of blood sugar control. There may be some relationship between the decrease of bilirubin level and the occurrence and development of diabetic retinopathy.