Abstract：Objective: To explore the predictive value of Hcy, HbA1c, and UA levels and the combined detection of the occurrence of diabetic retinopathy (DR). Methods: A total of 118 patients with type 2 diabetes mellitus (T2DM) who were diagnosed in the hospital from June 2020 to June 2024 were selected. All patients completed an eye exam within 1-2 weeks of admission. Based on the results of ophthalmic examination, 118 patients were divided into DR group (n=62) and NDR group (n=56). Serum Hcy,HbA1c,UA levels in the two groups were detected, and the differences in clinical indicators between two groups were compared with univariate analysis. The independent correlation between Hcy,HbA1c,UA level and DR occurrence was evaluated with multivariate Logistic regression analysis, and the predictive value of Hcy,HbA1c,UA level on DR was assessed by receiver operating characteristic (ROC) curve. Results: Hcy level, intraocular pressure, HbA1c, and UA in the DR group were higher than those in the NDR group (P<0.05). Multivariate Logistic regression analysis showed that Hcy, HbA1c, and UA were the influential factors of diabetic retinopathy (P<0.05). ROC curve analysis indicated that the combined detection of Hcy, HbA1c, and UA had a higher predictive value for DR, with an area under the curve (AUC) of 0.830 (95%CI: 0.750-0.893), which was higher than single detection (Z/P=2.137/0.032, 4.527/<0.001, 2.879/0.004). The sensitivity was 90.32% and the specificity was 66.07%. Conclusion: The elevated levels of serum Hcy, HbA1c and UA are correlated with the occurrence of DR and have high predictive value. The above indicators can be used as potential early screening indicators for DR, which is helpful for clinical risk stratification and early intervention.
王超, 董崇周, 章结楼, 明慧. Hcy HbA1c UA水平及联合检测对糖尿病视网膜病变发生的预测价值[J]. 河北医学, 2025, 31(7): 1164-1169.
WANG Chao, DONG Chongzhou, ZHANG Jielou, et al. Predictive Value of Hcy HbA1c and UA Levels and the Combined Detection of the Occurrence of Diabetic Retinopathy. HeBei Med, 2025, 31(7): 1164-1169.
[1] 胡卫文,周琼.ACE2/Ang 1-7/MasR轴在糖尿病视网膜病变中的作用研究进展[J].中华眼视光学与视觉科学杂志,2024,26(9):710-715. [2] 陈晓薇,刘力嘉,于业贤,等.基于区域健康数据平台开发新诊断2型糖尿病患者糖尿病视网膜病变发病风险预测模型及其应用[J].中华流行病学杂志,2024,45(9):1283-1290. [3] Kang Q,Yang C.Oxidative stress and diabetic retinopathy:molecular mechanisms,pathogenetic role and therapeutic implications[J].Redox Biol,2020,37(10):101799. [4] Feng R F,Liu H Y,Liu Y L,et al.Diabetes onset at an earlier age and high HbA1c levels as risk factors of diabetic retinopathy[J].Int Ophthalmol,2021,14(2):269-276. [5] 孙洪岩,罗小玲,孟婷,等.同型半胱氨酸和维生素B12及叶酸在糖尿病视网膜病变中的含量变化及临床意义[J].国际眼科杂志,2023,23(2):256-260. [6] Luo W M,Zhang Z P,Zhang W,et al.The association of homocysteine and diabetic retinopathy in homocysteine cycle in Chinese patients with type 2 diabetes[J].Front Endocrinol,2022,29(13):883845. [7] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].国际内分泌代谢杂志,2021,41(5):482-548. [8] 中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志,2014,50(11):851-865. [9] 李丹,汲宝兰,班博,等.2型糖尿病患者血清胆红素水平与糖尿病视网膜病变的相关性研究[J].中华内分泌代谢杂志,2020,36(3):227-234. [10] Bhatwadekar AD,Rameswara V.Circadian rhythms in diabetic retinopathy:an overview of pathogenesis and investigational drugs[J].Expert Opin Investig Drugs,2020,29(12):1431-1442. [11] 李孝才,房修岭,赵培沛.糖尿病视网膜病变患者血清Hcy、DLL4和SUA水平与糖脂代谢、胰岛素抵抗的关系[J].微循环学杂志,2024,34(3):50-54,60. [12] Li H,Liu X,Zhong H,et al.Research progress on the pathogenesis of diabetic retinopathy[J].BMC Ophthalmol,2023,23(1):372. [13] Chen X,Zhang X,Nie Y,et al.Circulating level of homocysteine contributes to diabetic retinopathy associated with dysregulated lipid profile and impaired kidney function in patients with type 2 diabetes mellitus[J].Eye,2023,37(7):1383-1389. [14] 罗宁,王玲玲.miR-409-3p通过靶向CACNB2调控糖尿病视网膜病变作用机制研究[J].国际检验医学杂志,2023,44(20):2508-2514. [15] Huang J,Yi Q,You Y,et al.Curcumin suppresses oxidative stress via regulation of ROS/NF-κB signaling pathway to protect retinal vascular endothelial cell in diabetic retinopathy[J].Molecular & Cellular Toxicology,2021,17(3):367-376.
2025, Vol. 31 
冀公网安备13080202000786号