| Objective:Objective to investigate the correlation and clinical significance of serum fasting C peptide,uric acid and T2DM retinopathy,and to define its prognostic value of diabetic retinopathy,so as to provide new evidence and ideas for the control and treatment of type 2 diabetic retinopathy.Method:A total of 266 patients with type 2 diabetes who were hospitalized in qinghai University Affiliated Hospital in November 2020-2021 were collected.And all patients met the inclusion and exclusion criteria.All patients improved the fundus photography,and according to the examination results,120 cases were divided into non-diabetic retinopathy group(NDR group),100 cases were divided into non proliferative retinopathy group(NPDR group)and 46 cases were divided into proliferative retinopathy group(PDR group).Collecting all selected patients the general information and uric acid(UA),triglyceride(TG),total cholesterol(TC),Cystatin C(Cys C),retinol binding protein(RBP),fasting C-peptide(FCP),glycosylated hemoglobin(Hb A1c).Applying the SPSS25.0 to analying the data.The indexes of the three groups were compared by ANOVA and nonparametric rank sum test,and the indexes between the two groups were compared by LSD,dunnet-t3 and Bonferroni test.The incidence of DR was compared among the three groups with different FCP and UA levels by chi square test.The correlation between FCP,UA and other continuous variables was analyzed by Pearson or Spearman.Taking diabetic retinopathy as dependent variable,FCP and UA as independent variables were included in logistic regression model to analyze the relationship between FCP,UA and diabetic retinopathy.Results:(1)There was no significant difference in BMI,LDL,WBC and PLT among the three groups(P>0.05).(2)There were significant differences in age,course of disease,FCP and UA between any two groups(P﹤0.05)。.(3)They were divided into three groups according to the reference range of FCP.The incidence of DR in groups with different C-peptide levels were79.2%,52.0%and 14.3%respectively.The incidence of DR was significant different among the three groups with different FCP levels(P﹤0.05).(4)Divided into four groups according to the quartile of UA,the incidence of DR in groups with different UA levels were 41.4%,46.2%,56.9%and75.8%respectively.The incidence of DR was significant different among the four groups with different UA levels(P﹤0.05).(5)The level of serum FCP level was negatively correlated with age(r=-0.178),course of disease(r_s=-0.428),Hb A1c(r=-0.166),HDL(r_s=-0.285),Cys C(r_s=-0.137),Cr(r_s=-0.153),FBG(r_s=-0.122)(P<0.05),and positively correlated with BMI(r=0.135)and TG(r_s=0.308)(P<0.05).(6)The level of serum UA was positively correlated with course of disease(r=0.221),SBP(r_s=0.158),DBP(r_s=0.184),BMI(r=0.122),Cys C(r_s=0.451),RBP(r_s=0.322),Cr(r_s=0.569)(P<0.05),and negatively correlated with HB(r=-0.240)and RBC(r=-0.253)(P<0.05).(7)Binary logistic regression analysis of risk factors for DR showed that age(OR=1.075,95%CI:1.027,1.126),course of disease(OR=1.217,95%CI:1.127,1.314),UA(OR=1.007,95%CI:1.001,1.012),DBP(OR=1.068,95%CI:1.012,1.127)were risk factors for DR(P<0.05),FCP(OR=0.597,95%CI:0.419,0.849)were protective factors for DR(P<0.05).Conclusion:(1)FCP is the protective factor of DR,and the incidence of DR decreases with the increase of FCP level.Increasing the level of C peptide is likely to be a new method to alleviate DR disease.(2)UA is a risk factor for DR,and the incidence of DR decreases with the decrease of UA level.Therefore,in the treatment of DR,we should not only pay attention to the management of blood glucose,but also pay attention to the level of UA. |
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