糖尿病视网膜病变患者餐后2 h 血糖升高对眼底图像中动静脉宽度比的影响

Effect of increased 2-hour postprandial blood glucose on arteriolar-to-venular diameter ratio in retinal fundus imaging of patients with diabetic retinopathy

摘要:

目的 探讨糖尿病视网膜病变（DR）患者餐后2 h 血糖（2 hPG）升高对眼底图像中动静脉宽度比（AVR）的影响。方法 选取DR 患者316 例，均行标准75 g 口服葡萄糖耐量试验（OGTT）检测空腹血糖（FPG）和餐后2 hPG，根据餐后血糖变化幅度（2 hPG-FPG）将所有研究对象按三分位分为3 组，低分位组（G1）104 例、中分位组（G2）108 例及高分位组（G3）104 例。测量各组眼底图像中AVR 水平，采用Pearson 相关性分析和多元线性回归分析DR 患者AVR 的影响因素。结果 ① G3 组和G2 组餐后2 hPG、空腹胰岛素（FIns）、糖化血红蛋白（HbA1c）及稳态模型评估- 胰岛素抵抗指数（HOMA-IR）均高于G1 组，且G3 组餐后2 hPG 和HbA1c 高于G2 组；G3 组和G2 组2 hAVR 较G1 组降低，G3 组较G2 组降低（P <0.05），而各组间空腹AVR比较，差异无统计学意义（P >0.05）；② Pearson 相关分析显示，AVR 与FPG、餐后2 hPG、HbA1c、收缩压（SBP）及舒张压（DBP）均呈负相关（P <0.05）；③多元线性回归分析显示，餐后2 hPG 为DR 患者AVR 的影响因素（P <0.05）。结论 餐后2 hPG 升高可能会导致AVR 降低，对DR 患者应动态观察AVR 的变化，对判断DR 的严重程度具有意义。

Abstract:

Objective To investigate the effect of increased 2-hour postprandial blood glucose on arteriolar-tovenular diameter ratio (AVR) in retinal fundus imaging of patients with diabetic retinopathy (DR). Methods A total of 316 DR patients were test by 75 g OGTT, FPG and 2 hPG were recorded, and all subjects were divided into G1 group (n = 104), G2 group (n = 108) and G3 group (n = 104) according to the rangeability of 2 hPG (2 hPG-FPG).The levels of AVR were measured in retinal fundus imaging. Correlation between AVR and other index were analyzed by Pearson correlation analysis and Multiple stepwise regression analysis. Results 2 hPG, FIns, HbA1c and HOMAIR in G3 group and G2 group were higher than those in G1 group, and 2 hPG and HbA1c in G3 group were higher than those in G2 group; 2 h AVR in G3 group and G2 group was lower than in G1 group respectively, and 2 h AVR in G3 group was lower than that in G2 group (P < 0.05), there was no statistical significance among three groups on F-AVR (P > 0.05). Pearson correlation analysis showed that AVR was negatively correlated with FPG, 2 hPG, HbA1c,SBP and DBP (P < 0.05); Multiple stepwise regression analysis showed that 2 hPG was influencing factor of AVR in DR patients (P = 0.000). Conclusion The increased 2 hPG maybe lead to the rise of AVR, and dynamic observation of AVR in DR patients should be more meaningful to judge the severity of the DR.