2023 年第 7 期 第 18 卷

糖尿病视网膜病变患者血清肌肉生长抑制素表达及临床意义

Expression and clinical significance of serum myostatin in patients with diabetic retinopathy

作者：解靖李新章索南措张琼陈媛婷

英文作者：Xie Jing Li Xinzhang Suo Nancuo Zhang Qiong Chen Yuanting

单位：青海红十字医院眼科,西宁810000

英文单位：Department of Ophthalmology Qinghai Red Cross Hospital Xining 810000 China

关键词：糖尿病；糖尿病视网膜病变；肌肉生长抑制素；危险因素

英文关键词：Diabetesmellitus;Diabeticretinopathy;Myostatin;Riskfactors

• 摘要：

• 目的  探讨糖尿病视网膜病变（DR）患者血清肌肉生长抑制素表达及临床意义。方法  选取2019年1月至2021年6月青海红十字医院收治的338例糖尿病患者，根据是否发生DR将患者分为DR组（122例）和非DR组（216例），根据DR分期标准将DR患者分为非增殖期视网膜病变（NPDR组，51例）、增殖期视网膜病变（PDR组，71例）。收集临床相关资料，检测血清肌肉生长抑制素水平。采用多因素Logistic回归模型分析2型糖尿病患者发生DR的危险因素。绘制受试者工作特征（ROC）曲线，分析肌肉生长抑制素对DR的诊断价值。结果  DR组男性比例、体重指数、2型糖尿病病程、糖尿病并发症比例、血清肌肉生长抑制素、空腹血糖、空腹胰岛素、稳态模型胰岛素抵抗指数（HOMA-IR）及糖化血红蛋白（HbA1c）水平均高于/长于非DR组，差异均有统计学意义（均P＜0.05）。PDR组血清肌肉生长抑制素水平高于NPDR组［（4 203±170）ng/L比（3 876±203）ng/L］（P＜0.001）。多因素Logistic回归分析结果显示HbA1c、HOMA-IR、糖尿病肾病、肌肉生长抑制素是2型糖尿病患者发生DR的独立危险因素（均P＜0.05）。ROC曲线分析结果显示，肌肉生长抑制素诊断DR的曲线下面积为0.797（95%置信区间：0.750～0.839，P＜0.001），敏感度为79.51%，特异度为81.48%，约登指数为0.609。结论  DR患者血清肌肉生长抑制素水平显著增高，且与DR发生以及严重程度有关，对DR具有较高的诊断价值。

• Objective  To investigate the expression and clinical significance of serum myostatin in patients with diabetic retinopathy (DR). Methods  From January 2019 to June 2021, 338 patients with type 2 diabetes mellitus admitted to Qinghai Red Cross Hospital were selected. They were divided into DR group (122 cases) and non-DR group (216 cases) according to whether they had DR. According to DR staging standard, patients with DR were divided into non-proliferative retinopathy (NPDR group, 51 cases) and proliferative retinopathy (PDR group, 71 cases). Clinical data of patients were collected and serum level of myostatin was detected. Multivariate Logistic regression method was used to analyze the risk factors of DR in patients with type 2 diabetes mellitus. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of myostatin in DR. Results  The male proportion, body mass index, duration of type 2 diabetes mellitus, proportion of complications of diabetes, serum levels of myostatin, fasting plasma glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and glycosylated hemoglobin (HbA1c) in DR group were higher/longer than those in non-DR group (all P<0.05). The serum level of myostatin in PDR group was higher than that in NPDR group ［（4 203±170）ng/L vs （3 876±203）ng/L］(P<0.001). Multivariate Logistic regression analysis showed that HbA1c, HOMA-IR, diabetic neuropathy and myostatin were risk factors of DR in patients with type 2 diabetes mellitus (all P<0.05). ROC curve analysis showed that the area under the curve of diagnosing DR with myostatin was 0.797(95% confidence interval: 0.750-0.839，P＜0.001), the sensitivity was 79.51%, the specificity was 81.48%, and the Youden index was 0.609. Conclusions    The serum level of myostatin significantly increases in patients with DR, which is related to the occurrence and severity of DR, it has a high diagnostic value for DR.