The Correlation Between Diabetic Retinopathy And Serum Retinol Binding Protein 4 In Type 2 Diabetes

Objective:1. To investigate risk factors of diabetic retinopathy in type 2 diabetes mellitus.2. To study the associations between RBP4 and the severity of diabetic retinopathy in type 2 diabetic patients.Methods:A total of 300 T2DM patients were recruited from the outpatients and inpatients of the Endocrinology Department at Union Hospital. There are 160 patients in no diabetic retinopathy, 110 patients in background retinopathy, and 30 patients in proliferative retinopathy. All patients who be selected were accepted routine physical examination, biochemistry test and OGTT. Then account the BMI and HOMA-IR of all the patients. All patients were picked up urine in 24 hours to detect tiny urine albumin level. Non-mydriatic fundus photography was used as a tool to identify diabetic retinopathy. If abnormality is detected, it will be confirmed by direct ophthalmoscope after papillary dilatation. If necessary, fundus fluorescence angiography will be adopted. Serum RBP4 will be determined by ELISA.Results:1. There are 160 cases in NDR (No diabetic retinopathy), 110 cases in BDR (background diabetic retinopathy), and 30 cases in PDR (proliferative diabetic retinopathy). The indexes of BMI, FBG, HBA1C, TG, TC, LDL and apoA1 have no significant differences among three groups.2. Factors involved in diabetic retinopathy are duration since the disease was diagnosed, WHR(waist-to-hip ratio),UAL(urinary microalbumin),HOMA-IR(insulin resistance index),FINS(fasting insulin)and HDL (high density lipoprotein)(P<0.01).3. The RBP4 level is relevant to HOMA-IR,UAL,FINS and HDL in multielement stepwise regression analysis .And it has a positive correlation of HOMA-IR, UAL, FINS; while has a negative correlation with HDL.4. There are no significant differences of RBP4 level between the NDR and BDR group. But RBP4 level between NDR and PDR are greatly different (P<0.001), and it is statistically different between BDR and PDR.Conclusion:1. The risk factors of diabetic retinopathy are duration of T2DM,waist-to-hip ratio,tiny urinary albumin,insulin resistance index and fasting insulin. High density lipoprotein is a benefit factor.2. The serum RBP4 level is relevant to diabetic retinopathy, and is positively correlative to the development of proliferative diabetic retinopathy (PDR).3. The serum RBP4 level is relevant to insulin resistance, urinary microalbumin and high density lipoprotein.