Correlation Analysis Between Type 2 Diabetic Retinopathy And Non-High-Density Lipoprotein Cholesterol To High-Density Lipoprotein Cholesterol Ratio

Purpose:To study the correlation between non-high-density lipoprotein cholesterol(non-HDL-C),non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio(NHHR)and diabetic retinopathy(DR),diabetic kidney disease(DKD)and diabetic peripheral neuropathy(DPN).To compare the correlation between non-HDL-C,NHHR,TC,TG,LDL-C,HDL-C and DR And their predictive value for DR,so as to provide a new method for clinical screening and early intervention of DR,and provide scientific basis for the clinical application of non-HDL-C and NHHR.Methods:A total of 367 patients with type 2 diabetes mellitus(T2DM)who were treated in the Department of Endocrinology and Metabolism of the First Affiliated Hospital of Nanchang University from June 1,2022 to December 31,2022 were enrolled.Fundus photography was performed by professional ophthalmologists.According to the examination results,the patients were divided into the simple T2 DM group(n=248)and the T2 DM with retinopathy group(n=119).The general data of the subjects were collected and recorded,including age,gender,height,weight,disease duration,systolic blood pressure(SBP),diastolic blood pressure(DBP),medication intake in the past 3 months,previous disease history and other routine data,and BMI was calculated.Fasting plasma glucose(FPG),1h postprandial plasma glucose(1H-PBG),2h postprandial plasma glucose(2H-PBG),glycated hemoglobin A1c(Hb A1C),fasting insulin,2h postprandial insulin,fasting C-peptide(FCP),postprandial 2h HC peptide,low density lipoprotein cholesterol(LDL-C)and glucose were collected on the second day of admission Triglyceride(TG),high density lipoprotein cholesterol(HDL-C),total cholesterol(TC),serum creatinine(Cr),urinary albumin/creatinine ratio(UACR)and other biochemical indicators were calculated.non-HDL-C and NHHR were calculated using known blood lipid indicators.The conditions of diabetic kidney disease(DKD)and diabetic peripheral neuropathy(DPN)were recorded.The final data analysis was performed using SPSS26.0.After K-S test of all measurement data,the normal distribution data were expressed by (?)±s,and the non-normal distribution data were described by median(interquartile range)[M(Q1,Q3)].The independent sample T Test or Wiicoxon rank sum test were used between groups.pearson or Spearman correlation analysis was used respectively.Binary logistic regression was used to analyze the risk factors related to DR.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of NHHR for diabetic retinopathy and calculate the area under the curve(AUC).There are statistics meanings(p<0.05)in the comparative difference among the groups.Result:(1)There were no significant differences in history of hypertension,SBP,DBP,BMI,gender,age and FCP between the two groups(p< 0.05);(2)The duration of diabetes,FPG,Hba1 c,TC,TG,LDL-C,non-high density lipoprotein cholesterol,non-high density lipoprotein cholesterol/high density lipoprotein cholesterol ratio in type 2 diabetes mellitus with DR Group were significantly higher than those in type 2 diabetes mellitus without Dr Group,while high density lipoprotein cholesterol was significantly lower than that in type 2diabetes mellitus without Dr Group.The differences between groups were statistically significant(p< 0.05);(3)DR Was positively correlated with the duration of diabetes,fasting blood glucose,Hb A1 C,TG,TC,LDL-C,non-HDL-C and NHHR,and negatively correlated with HDL-C(p< 0.05),and the correlation with NHHR(r=0.636)was stronger than other clinical indicators;(4)non-HDL-C was positively correlated with DR And DKD(p< 0.05),but had no significant correlation with DPN;(5)NHHR was positively correlated with DR And DKD(p< 0.05),and the correlation was stronger than that of non-HDL-C,but there was no significant correlation between DPN and HDL-C;(6)Binary Logistic regression analysis: The dependent variable was the occurrence of DR,and other clinical related indicators were independent variables.The results showed that the duration of diabetes,Hb A1 C,TC,TG,LDL-C,and non-HDL-C were independent risk factors for DR,and HDL-C was an independent protective factor for DR.After adjusting for the age,gender,duration of diabetes,FPG,and Hb A1 C,NHHR was still an independent risk factor for DR(OR=15.826,p< 0.01);(7)According to whether LDL-C reached the target(LDL-C< 2.6mmol/L)and non-HDL-C and NHHR exposure(non-HDL-C< 3.41mmol/L was non-exposed,NHHR< 3.2093 was non-exposed).The results showed that when LDL-C reached the standard,the incidence of DR In non-HDL-C or NHHR exposed group was higher than that in non-exposed group,and the difference was statistically significant.The proportion of DR In the group with LDL-C reaching the target and non-HDL-C or NHHR exposure was higher than that in the group with LDL-C not reaching the target and non-HDL-C or NHHR non-exposure,and the difference between the groups was statistically significant(p< 0.01);When non-HDL-C or NHHR were exposed,there was no significant difference in the incidence of DR Between the LDL-C target group and the LDL-C non-target group(p<0.05);(8)The predictive value of the related factors affecting DR Was analyzed.The results showed that NHHR(AUC=0.892,95%CI 0.861-0.924,p<0.01)was significantly higher than other clinical indicators,and the cut-off value was 3.488.Conclusion:(1)The levels of non-HDL-C and NHHR in T2 DM with DR Group were higher than those in T2 DM group.non-HDL-C and NHHR were independent risk factors for DR;(2)When LDL-C<At 2.6mmol/L,DR Was positively correlated with non-HDL-C and NHHR.When non-HDL-C and NHHR were exposed,there was no significant correlation between DR And LDL-C target;(3)The predictive value of NHHR for DR Was higher than that of TC,TG,LDL-C and non-HDL-C.