Correlation Analysis Between GA/HbA1c Ratio And Diabetic Retinopathy

Background and PurposeDiabetic retinopathy is a common ocular complication in diabetic patients.DR can cause irreversible visual impairment in adults and affect the life of diabetic patients.GA/HbA1c can reflect certain fluctuations in blood sugar,while long wave of high blood sugar can cause diabetes related to the occurrence of vascular and microvascular lesion,this study analyzes the risk of retinopathy in patients with type 2diabetes GA/HbA1c level,on the relationship of the GA/HbA1c with diabetic retinopathy were analyzed,and aims to provide relevant information for DR early intervention.Methods1571 patients with type 2 diabetic retinopathy admitted in Department of Endocrinology of Second Affiliated Hospital of Harbin Medical University from January 2018 to January 2019 were selected,including 1003 males and 568 females.All the patients met the World Health Organization(WHO)criteria fot the diagnosis and classification of diabetes mellitus in 1999.According to the international clinical staging standard of diabetic retinopathy,the patients were divided into 5 groups:background stage: 952 patients without obvious diabetic retinopathy(group A);Non-proliferative diabetic retinopathy(NPDR),including mild NPDR group 230cases(group B),moderate NPDR group 183 cases(group C),severe NPDR group 123cases(group D),proliferative diabetic retinopathy(PDR)83 cases(group E),these include early hyperplasia,fibrous hyperplasia and late hyperplasia.Relevant information and clinical data were collected: gender,age,disease course,smoking and alcohol history,height,weight,systolic blood pressure,diastolic blood pressure,etc.and body mass index(BMI)was calculated.HbA1c was determined by high speed liquid chromatography(Variant II automatic instrument produced by beller company),and GA was determined by enzyme method with automatic biochemical instrument.The above clinical data were analyzed by SPSS25.0 statistical software.Results1.The age,course of disease,systolic blood pressure,BMI,UACR,TC,TG,apo B,GA,HbA1c and GA/HbA1c in the fundus disease group were higher than those in the normal group(P<0.05).2.With the progression of fundus lesions,the HbA1c of group D was higher than that of group B.The difference was statistically significant(P=0.015).The GA of group D was higher than that of group B,and the GA of group E was higher than that of group B and C(P<0.001).GA/HbA1c in group D was higher than that in group B and C(P<0.05),group E was higher than that in group B,group C and D(P<0.05).3.GA/HbA1c was positively correlated with the course of disease and BMI,but negatively correlated with C-peptide 0min and C-peptide 120 min.4.The results of logistic regression analysis showed that C-peptide 0min,UACR and GA/HbA1c are the influencing factors of the progression of fundus lesions after controlling the course of disease and BMI,in which C-peptide 0min was the protective factor,that is,C-peptide 0min has a significant negative effect on the progression of fundus lesions,while UACR and GA/HbA1c were risk factors,that is,UACR and GA/HbA1c had significant positive effects on the progression of fundus lesions.Conclusions1.GA/HbA1c is a risk factor for the occurrence and development of DR.2.BMI and the course of diabetes were positively correlated with GA/HbA1c,while C-peptide 0min and C-peptide 120 min were negatively correlated with GA/HbA1c.3.DR is associated with age,course of disease,systolic blood pressure,BMI,UACR,TC,TG,Apo B,GA,HbA1c and GA/HbA1c.