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投稿时间：2025-02-14 网络发布日期：2025-12-25
投稿时间：2025-02-14 网络发布日期：2025-12-25
中文摘要: 目的 分析胰岛素样生长因子结合蛋白-3（IGFBP-3）、C1q/肿瘤坏死因子相关蛋白5（CTRP5）、半乳糖凝集素-3（Galectin-3）与糖尿病视网膜病变（DR）之间的关系，探讨三者对DR发生的预测作用。方法 选取重庆医科大学附属大足医院2023年1月至8月收治的106例DR患者以及同期105例单纯2型糖尿病（T2DM）患者，分别纳入DR组和T2DM组。对比DR组和T2DM组的临床资料及实验室指标，应用二元logistic回归模型分析DR发生的影响因素，绘制受试者工作特征（ROC）曲线分析IGFBP-3、CTRP5、Galectin-3水平及三者联合检测对DR的诊断价值。结果 两组性别、年龄、身体质量指数（BMI）、饮酒史、吸烟史、三酰甘油、总胆固醇、血肌酐水平比较差异均无统计学意义（P>0.05）；DR组T2DM病程长于T2DM组［（10.42±2.37）年 vs（7.81±2.19）年，t=4.575，P<0.01］，DR组空腹血糖（FPG）、糖化血红蛋白（HbA1C）、空腹胰岛素（FINS）、稳态模型评估胰岛素抵抗指数（HOMA-IR）、IGFBP-3、CTRP5、Galectin-3水平均高于T2DM组（P<0.05）。回归分析结果显示：较长的T2DM病程（OR=2.672，95%CI:1.433~4.984）及高水平的HbA1C（OR=2.654，95%CI:1.339~5.260）、HOMA-IR（OR=5.171，95%CI:1.956~13.669）、IGFBP-3（OR=2.113，95%CI:1.223~3.650）、CTRP5（OR=4.183，95%CI:1.507~11.613）和Galectin-3（OR=5.743，95%CI:1.658~19.898）是 DR 发生的独立危险因素（P<0.01）。ROC结果显示，IGFBP-3、CTRP5、Galectin-3 水平及三者联合预测DR发生的曲线下面积（AUC）分别为0.815、0.811、0.886、0.901，灵敏度分别为84.91%、79.25%、78.30%、77.36%，特异度分别为66.67%、71.43%、90.48%、91.43%。结论 DR的发生与T2DM病程、HbA1C、HOMA-IR、IGFBP-3、CTRP5、Galectin-3水平存在密切联系。临床可通过对IGFBP-3、CTRP5、Galectin-3水平的联合检测来预测DR的发生。
Abstract:Objective To analyze the relationship of insulin-like growth factor binding protein-3 (IGFBP-3), C1q/ tumor necrosis factor related protein-5 (CTRP5), galactoagglutinin-3 (Galectin-3) with diabetes retinopathy (DR), and to explore the predictive effect of these three on the occurrence of DR. Methods A total of 106 patients with DR and 105 patients with simple type 2 diabetes mellitus (T2DM) in the Affiliated Dazu's Hospital of Chongqing Medical University from January to August 2023 were selected and included in DR group and T2DM group respectively. The clinical data and laboratory indicators were compared between DR patients and simple T2DM patients. Binary logistic regression model was used to analyze the influencing factors of DR occurrence, and receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic value of IGFBP-3, CTRP5 and Galectin-3 levels on DR. Results There was no statistical difference in gender, age, body mass index (BMI), drinking history, smoking history, triglyceride, total cholesterol and serum creatinine between groups (P>0.05). The disease course of T2DM in DR group was longer than that in T2DM group [ (10.42±2.37) years vs (7.81±2.19) years, t=4.575, P<0.01], and fasting plasma glucose (FPG), glycated hemoglobin (HbA1C), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), IGFBP-3, CTRP5 and Galectin-3 were higher than those in T2DM group (P<0.05). Regression analysis suggested that long T2DM course (OR=2.672, 95%CI: 1.433-4.984) and high levels of HbA1C (OR=2.654, 95%CI: 1.339-5.260), HOMA-IR (OR=5.171, 95%CI: 1.956-13.669), IGFBP-3 (OR=2.113, 95%CI: 1.223-3.650), CTRP5 (OR=4.183, 95%CI: 1.507-11.613) and Galectin-3 (OR=5.743, 95%CI: 1.658-19.898) were independent risk factors for DR (P<0.05). ROC results indicated that the area under curve (AUC) of IGFBP-3, CTRP5, Galectin-3 and their combination on predicting DR were 0.815, 0.811, 0.886 and 0.901, and the sensitivities were 84.91%, 79.25%, 78.30% and 77.36%, and the specificities were 66.67%, 71.43%, 90.48% and 91.43% respectively, and the predictive efficiency was higher (P<0.05). Conclusion The occurrence of DR is closely related to the course of T2DM, HbA1C, HOMA-IR, IGFBP-3, CTRP5 and Galectin-3 levels. The occurrence of DR can be predicted the combined detection IGFBP-3, CTRP5 and Galectin-3.
keywords: Insulin-like growth factor binding protein-3 C1q/tumor necrosis factor-related protein 5 Galectin-3 Insulin resistance index Glycated hemoglobin Diabetic retinopathy
文章编号： 中图分类号：R587.2 文献标志码：A
基金项目:重庆市卫生健康委中医药科研项目（2024WSJK140）；重庆市大足区科技发展项目（DZKJ2022JSYJ-KWXM1012）
附件
| 作者 | 单位 |
| 田明洁 | 重庆医科大学附属大足医院眼科,重庆 402360 |
| 陈先理 | 重庆医科大学附属大足医院重症医学科,重庆 402360 |
| 刘星 | 重庆医科大学附属大足医院眼科,重庆 402360 |
| 冯毅 | 重庆医科大学附属大足医院眼科,重庆 402360 |
引用文本：
田明洁,陈先理,刘星,等.IGFBP-3、CTRP5、Galectin-3与糖尿病视网膜病变的相关性分析[J].中国临床研究,2025,38(12):1913-1917.
田明洁,陈先理,刘星,等.IGFBP-3、CTRP5、Galectin-3与糖尿病视网膜病变的相关性分析[J].中国临床研究,2025,38(12):1913-1917.