Retinol Binding Protein 4, Homocysteine And Correlation Study Of Diabetic Retinopathy

Objectives The purpose of this research is to discuss the evolution and correlation of several indicators of patients with different stages of the diabetic retinopathy, including retinol binding protein 4, homocysteine, hemoglobin A1c(Hb A1c), age of patients and blood fat, as well as how these indicators are correlated with the fluorescein fundus angiography(FFA) results in order to provide some theoretical evidence for the prophylaxis and treatment of the diabetic retinopathy.Methods 1 Samples for Analysis: 76 inpatients from the endocrinology department of the affiliated hospital of Hebei United University who are diagnosed as type 2 diabetic mellitus(T2DM) based on the diagnosis and classification standards of diabetes issued by WHO in 1999. The 76 samples are divided into 3 groups: 27 samples who have T2 DM without diabetic retinopathy, 24 samples who have T2 DM with nonproliferative diabetic retinopathy(NPDR) and 25 samples who have T2 DM with proliferative diabetic retinopathy(PDR). Besides, there is a control group including 30 healthy individuals. The differences in terms of gender, age and smoking behavior among the 4 groups are statistically insignificant(P>0.05).2 Retinol binding protein 4(RBP 4) is measured by radioimmunoassay(ELISA) and the HCY, TC, TG, LDC-C, HDL-C and Hb A1 C measures are collected from each sample’s venous blood. 3. The data is organized in Excel and analyzed in SPSS21.0. All estimates are shown in the format of( x ±s), all measures are tested against the χ2distribution, the MANOVA is employed for comparison among groups, Pearson correlation analysis and multiple stepwise regression analysis are applied to all indicators. The relationship between the probability of DR and all indicators of interest is examined by the Logistic regression which indicates some statistically significant relationships with P<0.05.Results 1 The difference in gender composition and age distribution among 3 groups of T2 DM patients and the control group is not statistically significant according to the χ2 test(P>0.05), which guarantees the validity of comparison among groups. The course of disease are statistically significantly(P<0.05) different among the 3 groups of patients. The BMI of 3 groups of patients is statistically significantly(P<0.05) higher than the healthy control group, the difference in BMI among the 3 groups of patients are not statistically significant(P>0.05). 2 The FPG, Hb A1 C, TG, TC and LDL-C of the 3 patients groups are higher than the control group and the patients groups, HDL-C is lower than the control group. The Hb A1 C, FPG and TG of the NPDR and PDR groups are higher than T2 DM group and the three measures of the PDR group are also higher than the NPDR group. The HDL-C of the PDR group is lower than the T2 DM and NPDRgroups. All of the above results are statistically significant(P<0.05). The HDL-C is not significantly different between the T2 DM and NPDR groups(P>0.05) and the TC and LDL-C are not statistically different among the 3 patients groups(P>0.05). 3 The RBP4 and HCY of the patients group are higher than the control group and the levels of the two indicators increase with course of disease among the 3 patients groups. The results are statistically significant(P<0.05). 4 Using RBP4 as dependent variable, the correlation analysis shows that RBP4 is positively correlated(P<0.05) with course of disease, BMI, FPG, Hb A1 C, TC, TG, LDL-C and HCY, negatively correlated with HDL-C(P<0.05) and not significantly correlated with gender or age(P>0.05). Similarly, using HCY as dependent variable, HCY is positively correlated(P<0.05) with course of disease, BMI, FPG, Hb A1 C, TC, TG, LDL-C and RBP4, negatively correlated with HDL-C(P<0.05) and not significantly correlated with gender or age(P>0.05). 5 The multiple stepwise regression analysis with RBP4 as dependent variable and course of disease, BMI, FPG, Hb A1 C, TG, TC, LDL-C and HDL-C as independent variables shows RBP4 is positively correlated with BMI, Hb A1 C, TG(P<0.05), negatively correlated with HDL-C(P<0.05) and not correlated with others(P>0.05). A similar regression with dependent variable replaced by HCY shows that HCY is positively correlated with BMI, PFG, Hb A1 C, TG(P<0.05), negatively correlated with HDL-C(P<0.05) and not correlated with others(P>0.05).6 Using the occurrence of diabetic retinopathy as dependent variable, course of disease, BMI, FPG, Hb A1 C, TC, TG, LDL-C, HDL-C, HCY and RBP4 as independent variables, the logit regression results show DR is positively correlated with HCY, RBP4 and HbA1C(P<0.05) but not correlated with others(P>0.05).Conclusions 1 The evidence that RBP4 and HCY of patients with DR are significantly higher than patients without DR. 2 The RBP4 and HCY of patients with type 2 diabetes increase with the development of diabetic retinopathy.3 RBP4 and HCY may be an important risk factors of diabetic retinopathy.