Predictive Value Of UACR,Cystatin And C-Peptide In Type 2 Diabetic Retinopathy

Objective: to determine the influencing factors of DR and to evaluate the diagnostic value of UACR,cystatin C and fasting C peptide in DR.Methods: 378 patients with T2 DM were selected from the Department of Endocrinology,the first affiliated Hospital of Xinjiang Medical University from January 2018 to December 2022.They were divided into normal group(n=120),non-proliferative retinopathy(NPDR)group and proliferative retinopathy(PDR)group(n=44).The general data and laboratory indexes of patients were collected,and the differences of general data and laboratory indexes in different groups were compared.Ordered Logistic regression was used to analyze the risk factors of DR,and the predictive value of risk factors of DR to DR was evaluated by receiver operating characteristic curve(ROC)curve.At the same time,the AUC differences of serum cystatin C,UACR and fasting C peptide in the diagnosis of DR were compared.Results: 1)There were significant differences in age,creatinine,uric acid,systolic blood pressure,course of disease,e GFR,urinary Microalbumin,UACR,serum apolipoprotein a,total bilirubin,fasting C peptide,2h C peptide and history of hypertension among the three groups;2)The results of ordered Logistic regression analysis showed that UACR,systolic blood pressure and course of disease were independent risk factors for DR.C-peptide is a protective factor in the occurrence of DR.The results of;3)ROC curve analysis showed that the best cutoff values of UACR,cystatin and C-peptide for predictive diagnosis of DR were 0.905,3.49 and 1.220,respectively.The AUC of the combined detection of the three indicators for the diagnosis of DR is 0.75.The sensitivity is 0.725,the specificity is 0.691,and the maximum Jordan index is 0.416.The AUC of three combined tests for diagnosis of DR was significantly higher than that of three separate diagnoses and two combined diagnoses.Conclusion:UACR,systolic blood pressure and course of disease are independent risk factors of DR,fasting C-peptide is the protective factor of DR,DR is easy to occur when UACR >0.905mg/mmol,cystatin C-gt;3.49mg/L and fasting C-peptide < 1.220,the combined detection of three indexes has good diagnostic value for DR,and the diagnostic value of combined detection of three indexes is better than that of single and two indexes.