血清唾液酸与2型糖尿病视网膜病变的相关性研究
The Relationship between Serum Sialic Acid and Type 2 Diabetic Retinopathy

目的：探讨2型糖尿病(T2DM)患者血清唾液酸(SA)与视网膜病变(DR)的相关性。方法：纳入毓璜顶医院内分泌科及眼科630例T2DM患者，分为非DR (NDR)组(n = 219)、非增生性DR (NPDR)组(n = 197)和增生性DR (PDR)组(n = 214)，收集资料，分析组间差异，采用多元有序logistic回归分析SA与DR的关系。结果：三组在性别、体重指数、腰臀比、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)比较差异无统计学意义；三组在年龄、病程、高血压、冠心病、糖化血红蛋白(HbA1c)、SA、胱抑素C (Cys-C)、低密度脂蛋白胆固醇(HDL-C)、血同型半胱氨酸(HCY)、尿酸(UA)、空腹C肽(FCP)比较差异具有统计学意义(P < 0.05)。将P值<0.05的指标纳入研究，采用多元有序logistics回归分析结果显示，DM病程、年龄、血清SA、FCP是影响DR的独立危险因素(P < 0.05)。结论：血清SA浓度是DR的危险因素，关注SA水平可能有助于DR的早期发现和疾病严重程度的监测。
Objective: To investigate the correlation between serum sialic acid (SA) and retinopathy (DR) in type 2 diabetes mellitus (T2DM) patients. Methods: 630 T2DM patients in department of Endocri-nology and Ophthalmology of Yuhuangding Hospital were divided into non-DR group (n = 219), non-hyperplastic DR Group (n = 197) and hyperplastic DR Group (n = 214). Data were collected and the differences among the groups were analyzed. Multiple ordered logistic regression was used to analyze the relationship between SA and DR. Results: There were no significant differences in gen-der, waist-to-hip ratio, body mass index, fasting blood glucose (FBG), total cholesterol (TC), triglyc-eride (TG) and low-density lipoprotein cholesterol (LDL-C) among the three groups. There were sig-nificant differences in age, duration of illness, presence or absence of hypertension and coronary heart disease, glycosylated hemoglobin (HbA1c), SA, Cys-C, HDL-C, HCY, UA and FCP among the three groups (P < 0.05). Indexes with P value <0.05 were included in the study, followed by multiple or-dered logistics regression analysis. The results showed that the disease course of DM, age, serum SA and FCP were independent risk factors for DR (P < 0.05). Conclusion: The increase of serum SA con-centration is related to the severity of DR. Focusing on SA levels may contribute to early detection of DR and monitoring of disease severity.