[1]张震英,田春雨,赵乐,等.血清FPG 及HbA1c 水平检测对2 型糖尿病继发干眼症的预测价值研究及危险因素分析[J].现代检验医学杂志,2020,35(05):68-72.[doi:10.3969/j.issn.1671-7414.2020.05.018]
　ZHANG Zhen-ying,TIAN Chun-yu,ZHAO Le,et al.Study on the Predictive Value of Serum FPG and HbA1c Level in Dry Eye Secondary to Type 2 Diabetes Mellitus and Analysis of Risk Factors[J].Journal of Modern Laboratory Medicine,2020,35(05):68-72.[doi:10.3969/j.issn.1671-7414.2020.05.018]
点击复制

血清FPG 及HbA1c 水平检测对2 型糖尿病继发干眼症的预测价值研究及危险因素分析()
分享到：

《现代检验医学杂志》[ISSN:/CN:]

卷:
第35卷
期数:
2020年05期
页码:
68-72
栏目:
论著
出版日期:
2020-11-01

文章信息/Info

Title:
Study on the Predictive Value of Serum FPG and HbA1c Level in Dry Eye Secondary to Type 2 Diabetes Mellitus and Analysis of Risk Factors
文章编号:
1671-7414（2020）05-068-05
作者:
张震英1; 田春雨2; 赵乐1; 闫小艺1; 郑继香1
1. 唐山市眼科医院眼肌科, 河北唐山 063000;2. 唐山市开平医院五官科, 河北唐山 063021
Author(s):
ZHANG Zhen-ying 1 ; TIAN Chun-yu 2 ; ZHAO Le 1; YAN Xiao-yi 1; ZHENG Ji-xiang 1
1.Department of Ophthalmologia，Eye Hospital of Tangshan，Hebei Tangshan 063000,China;2.Department of Ophthalmology and Otorhinolaryngology，Kaiping Hospital of Tangshan，Hebei Tangshan 063021,China
关键词:
2 型糖尿病继发干眼症; 糖化血红蛋白; 空腹血糖
分类号:
R587.2；R446.11
DOI:
10.3969/j.issn.1671-7414.2020.05.018
文献标志码:
A
摘要:
目的　探讨血清空腹血糖（fasting blood glucose，FPG）及糖化血红蛋白（glycosylated hemoglobin，HbA1c） 水平检测对2 型糖尿病继发干眼症的预测价值研究及危险因素分析。方法　选择唐山市眼科医院2017 年8 月～ 2019 年8 月收治的60 例2 型糖尿病继发干眼症患者为干眼症组，另外纳入同期于该院治疗的60 例2 型糖尿病患者为糖尿 病组。对比两组基础资料（年龄、性别、病程、泪腺功能、胰岛素分泌以及FPG,HbA1c 水平），采用ROC 曲线分析 FPG,HbA1c 水平预测2 型糖尿病患者发生干眼症价值；采用Logistic 回归分析模型，明确2 型糖尿病患者发生干眼症 的危险因素。结果　经单因素分析，两组年龄、性别以及病程比较，差异无统计学意义（t=0.134, χ2=0.186,t=0.223, 均P ＞ 0.05）；干眼症组存在泪腺功能障碍、胰岛素分泌不足患者显著多于糖尿病组，差异有统计学意义（χ2=5.829,8.336， 均P ＜ 0.05）；干眼症组FPG,HbA1c 水平显著高于糖尿病组，差异有统计学意义（t=2.922，5.925，均P ＜ 0.05）。 经ROC分析FPG 和HbA1c 的曲线下面积分别为0.738 和0.701，标准差分别为0.045 和0.047，95%CI 分别为0.651 ～ 0.825 和0.609~0.794，最佳截断值分别为8.765mmol/L 和6.875%，敏感度分别为0.567 和0.933，特异度分别为0.750 和0.400。 经Logistic 回归性分析证实存在泪腺功能障碍、胰岛素分泌不足、FPG ＞ 8.765mmol/L 以及HbA1c ＞ 6.875% 是2 型糖 尿病患者发生干眼症的危险因素。结论　影响2 型糖尿病患者发生干眼症的危险因素较多，如存在泪腺功能障碍、胰岛 素分泌不足以及FPG,HbA1c，其中FPG ＞ 8.765mmol/L 和HbA1c ＞ 6.875% 是预测2 型糖尿病患者发生干眼症的最佳 截断值，在预防2 型糖尿病患者发生干眼症的过程中具有一定的参考价值，临床应当关注。
Abstract:
Objective　To investigate the predictive value of serum fasting blood glucose (FPG) and glycosylated hemoglobin (HbA1c) levels in dry eyes secondary to type 2 diabetes mellitus and risk factor analysis. Methods　From August 2017 to August 2019, 60 patients with dry eye disease and type 2 diabetes were selected as the combined group, and 60 patients with type 2 diabetes were included in the same period in their hospital as the diabetes group. Comparing the basic data of the two groups （age, gender, course of disease, lacrimal gland function, insulin secretion and FPG, HbA1c levels）, ROC curve was used to analyze FPG and HbA1c levels to predict the value of dry eye in patients with type 2 diabetes, and logistic regression model was used to identify the risk factors of dry eye in patients with type 2 diabetes. Results　By single factor analysis, there was no significant difference in age, gender and course of disease between the two groups (t=0.134, χ2=0.186,t=0.223, all P >0.05),the patients with lacrimal gland dysfunction and insufficiencies of insulin secretion in the combined group were significantly more than those in the diabetes group (χ2=5.829,8.336，all P <0.05) and the levels of FPG and HbA1c in the combined group were significantly higher than those in the diabetes group (t=2.922，5.925，all P < 0.05). By ROC analysis, the area of the lower curve of FPG and HbA1c was 0.738 and 0.701, the standard error was 0.045 and 0.047, the 95% CI was 0.651~0.825 and 0.609~0.794, the best truncation value was 8.765mmol/L and 6.875%, the sensitivity was 0.567 and 0.933,and the specificity was 0.750 and 0.400, respectively. Logistic regression analysis confirmed that the presence of lacrimal gland dysfunction, insufficiencies of insulin secretion, FPG > 8.765mmol/L and HbA1c > 6.875% were the risk factors of dry eye in type 2 diabetic patients. Conclusion There are many risk factors affecting dry eye in type 2 diabetes patients, such as lacrimal gland dysfunction, insufficient insulin secretion and FPG,HbA1c, FPG>8.765mmol/L and HbA1c FPG>6.875% are the best cut-off values to predict dry eye in type 2 diabetes patients.

参考文献/References:

[1]　 CZECH M P. Insulin action and resistance in obesity and type 2 diabetes[J]. Nature Medicine, 2017, 23(7):804-814.
[2]　 NCD Risk Factor Collaboration (NCD-RisC) – Africa Working Group. Trends in obesity and diabetes across africa from 1980 to 2014: an analysis of pooled population-based studies[J].International Journal of Epidemiology, 2017,46(5):1421-1432.
[3]　 SOLIMAN E Z,BACKLUND JYE-YU C,BEBU I, et al. Electrocardiographic abnormalities and cardiovascular disease risk in type 1 diabetes: the epidemiology of diabetes interventions and complications (EDIC) study [J]. Diabetes Care, 2017,40(6): 793-799.
[4]　 FORBES J M， FOTHERINGHAM A K .Vascular complications in diabetes:old messages,new thoughts[J]. Diabetologia, 2017, 60(11): 2129-2138.
[5]　 PAREEK M, SCHAUER P R, KAPLAN L M, et al. Metabolic surgery: weight loss, diabetes, and beyond[J]. Journal of the American College of Cardiology, 2018, 71(6): 670-687.
[6]　 ERIKSSON J W, LUNDKVIST P, JANSSON Per- Anders,et al. Effects of dapagliflozin and n-3 carboxylic acids on non-alcoholic fatty liver disease in people with type 2 diabetes: a double-blind randomised placebocontrolled study.[J]. Diabetologia,2018, 61(9): 1923- 1934.
[7]　 王蓉，曾洁梅，徐邦牢．探讨基质金属蛋白酶-9 在 干眼症患者泪液中的表达及临床意义[J]．现代检验 医学杂志, 2014, 29（3）: 73-74． 　　 WANG Rong, ZENG Jiemei, X? Banglao. Expression and its significance of matrix metalloproteinases-9 in tears of patients with xerophthalmia [J].] Journal of Modern Laboratory Medicine ,2014,29(3):73-74.
[8]　 中华医学会糖尿病学分会．中国2 型糖尿病防治指 南(2007 年版)[J]．中华医学杂志，2008，88（18）： 1227-1245． 　　 Chinese Diabetes Society of Chinese Medical Association. Guidelines for the prevention and treatment of type 2 diabetes in China (2007) [J]. National Medical Journal of China, 2008, 88(18): 1227- 1245.
[9]　 中华医学会眼科学分会角膜病学组．干眼临床诊疗 专家共识(2013 年)[J]．中华眼科杂志，2013，49（1）： 73-75． 　　 Cornea Group of Ophthalmology Society of Chinese Medical Association. Consensus on clinical diagnosis and treatment of dry eye (2013) [J]. Chinese Journal of Ophthalmology, 2013, 49 (1): 73-75.
[10] 于莉，黎明，周晓萍，等．睑板腺功能障碍性干眼 症临床治疗探讨[J]．中国实用眼科杂志, 2014, 32 （1）: 76-78． 　　 YU Li, LI Ming, ZHOU Xiaoping, et al. The research on clinical treatment of dry eye syndrome caused by meibomian gland dysfunction [J]. Chinese Journal of Practical Ophthalmology, 2014, 32 (1): 76-78.
[11] 何佳佳，王雁，赵勇．睑板腺功能障碍的物理治疗 方法及其进展[J]．国际眼科杂志, 2019, 19（7）: 1146-1149． HE Jiajia, WANG Yan, ZHAO Yong. Physical therapy of meibomian gland dysfunction and its progress[J]. International Eye Science, 2019,19 (7): 1146-1149
[12] 邓显峰，朱峰，陈伟，等．2 型糖尿病与干眼症的相关性研究及其危险因素分析[J]．现代生物医学进 展, 2016, 16（13）: 2503-2506． 　　 DENG Xianfeng, ZHU Feng, CHEN Wei, et al. Research on the relation between type 2 diabetes mellitus and dry eye disease and analysis on the risk factors [J]. Progress in Modern Biomedicine, 2016, 16 (13): 2503-2506
[13] 白淑玮，李凤至．糖尿病与非糖尿病干眼症患者临 床特点及相关细胞因子表达研究[J]．陕西医学杂志， 2016, 45（4）: 477-479． 　　 BAI Shuwei, LI Fengzhi. Study on cl inical characteristics and expression of related cytokines in diabetic and non diabetic dry eye patients [J]. Shaanxi Medical Journal, 2016, 45 (4): 477-479
[14] 边小燕，岑明辉，张小利，等．眼睑形态学与干 眼发病程度的相关性研究[J]. 中国实用眼科杂志， 2015, 33（z1）: 47-49． 　　 BIAN Xiaoyan, CEN Minghui, ZHANG Xiaoli, et al. The correlation study of eyelid morphology and severity of dry eye [J]. Chinese Journal of Practical Ophthalmology, 2015,33 (z1): 47-49
[15] 左春兰．干眼症的相关因素分析[J]．中国实用眼科 杂志, 2015, 33（z1）: 1-3． 　　 ZUO Chunlan. Analysis of related factors of dry eye[J]. Chinese Journal of Practical Ophthalmology, 2015, 33(z1): 1-3.
[16] 蒋兆荣，董超，陈冰，等．2 型糖尿病患者泪膜稳 定性相关因素分析[J]．中国医学创新，2019，16（7）： 77-81． 　　 JIANG Zhaorong, DONG Chao, CHEN Bing, et al. Analysis of related factors of tear film stability in patients with type 2 diabetes mellitus[J]. Medical Innovation of China, 2019,16 (7): 77-81
[17] 唐颖，田甜，葛红岩. 干眼症发病机制与发病因素 的研究进展[J]. 医学综述, 2019, 25（11）: 2196- 2201． 　　 TANG Ying, TIAN Tian, GE Hongyan. Research development of pathogenesis and influence factors in xerophthalmia[J]. Medical Recapitulate , 2019,25 (11): 2196-2201
[18] 王淑兰．干眼症研究进展的综述[J]．世界最新医学 信息文摘( 连续型电子期刊)，2018, 18（11）: 32- 33, 38． 　　 WANG Shulan. Review of the research progress of dry eye [J]. World Latest Medicine Information (Electronic Version), 2018, 18（11）:32-33, 38

相似文献/References:

[1]靳庆娥,乌姗娜,张亚鑫,等.血清糖化血红蛋白和CA15-3水平检测与女性乳腺癌发病风险的相关性研究[J].现代检验医学杂志,2019,34(04):143.[doi:10.3969/j.issn.1671-7414.2019.04.035]
　JIN Qing-e,WU Shan-na,ZHANG Ya-xin,et al.Relationship of Glycosylated Hemoglobin A1c and Tumor Marker CA15-3 Levels in Serum with Breast Cancer Susceptibility in Women of Beijing Area[J].Journal of Modern Laboratory Medicine,2019,34(05):143.[doi:10.3969/j.issn.1671-7414.2019.04.035]
[2]孔丽蕊,黄　英,张　艳,等.血糖、糖化血红蛋白的参考变化值和参考变化因子的应用研究[J].现代检验医学杂志,2020,35(03):110.[doi:10.3969/j.issn.1671-7414.2020.03.029]
　KONG Li-rui,HUANG Ying,ZHANG Yan,et al.Application Study of Reference Change Value and Reference Change Factor of Blood Glucose and Glycated Hemoglobin[J].Journal of Modern Laboratory Medicine,2020,35(05):110.[doi:10.3969/j.issn.1671-7414.2020.03.029]
[3]赵淑珍,郑锦仁,陈媛,等.血清糖化清蛋白检测方法学评价、临床性能验证及其在糖尿病监测的应用研究[J].现代检验医学杂志,2020,35(05):77.[doi:10.3969/j.issn.1671-7414.2020.05.020]
　ZHAO Shu-zhen,ZHENG Jin-ren,CHEN Yuan,et al.Application of Glycated Albumin in Diabetes Monitoring Indicators[J].Journal of Modern Laboratory Medicine,2020,35(05):77.[doi:10.3969/j.issn.1671-7414.2020.05.020]
[4]陈丽华a,王思思b,朱婕曼a,等.高龄产妇孕中期血清 FPG，HbA1c 及 TC 联合检测预测 GDM 风险的临床研究[J].现代检验医学杂志,2020,35(06):33.[doi:doi:10.3969/j.issn.1671-7414.2020.06.009]
　CHEN Li-hua a,WANGg Si-si b,ZHU Jie-man a,et al.Clinical Study on Prediction of GDM Risk by Combined Detection of SerumFPG, HbA1c and TC in the Second Trimester of Pregnancy in Elderly Women[J].Journal of Modern Laboratory Medicine,2020,35(05):33.[doi:doi:10.3969/j.issn.1671-7414.2020.06.009]
[5]黄明兰,柯晓斯,彭致平,等.正常妊娠期妇女低色素性贫血对糖化血红蛋白水平检测的影响[J].现代检验医学杂志,2021,36(02):151.[doi:doi:10.3969/j.issn.1671-7414.2021.02.036]
　HUANG Ming-lan,KE Xiao-si,PENG Zhi-ping,et al.Effect of Hypopigmentation Anemia on Glycosylated Hemoglobin in Normal Pregnant Women[J].Journal of Modern Laboratory Medicine,2021,36(05):151.[doi:doi:10.3969/j.issn.1671-7414.2021.02.036]
[6]汤小峰,蒋艺兰,朱 蓓.糖尿病性骨质疏松患者雌激素受体α 基因XbaI（rs9340799）SNP 和HbA1c 水平交互作用与疾病易感性分析[J].现代检验医学杂志,2023,38(01):38.[doi:10.3969/j.issn.1671-7414.2023.01.008]
　TANG Xiao-feng,JIANG Yi-lan,ZHU Bei.Analysis of Interaction between Estrogen Receptorα Gene XbaI (rs9340799) SNP and HbA1c Level and Disease Susceptibility in Patients with Diabetes Osteoporosis[J].Journal of Modern Laboratory Medicine,2023,38(05):38.[doi:10.3969/j.issn.1671-7414.2023.01.008]

备注/Memo

备注/Memo:
基金项目：河北省医学科学研究重点课题计划项目（20191639）。
作者简介：张震英（1976-），女，本科，主治医师，从事眼科学方面研究，E-mail:826696874@qq.com。
更新日期/Last Update: 2020-10-30