目的：探讨血清中鸢尾素(Irisin)、基质金属蛋白酶-9(matrix metalloproteinase 9, MMP-9)、血管内皮生长因子(vascular endothelial growth factor, VEGF)联合检测对2型糖尿病(type 2 diabetes, T2DM)视网膜病变(diabetic retinopathy, DR)的预测价值。方法：选取2022年11月至2023年11月在内蒙古自治区人民医院住院的患者及健康体检者共200例,根据DR进程分4组,ELISA 法检测血清 Irisin、MMP-9、VEGF并进行相关性分析、ROC曲线分析和多元回归分析。结果：2型糖尿病不伴视网膜病变(non-diabetic retinopathy, NDR)组、非增殖性糖尿病视网膜病变(non proliferative diabetes retinopathy, NPDR)组、增殖性糖尿病视网膜病变(proliferative diabetes retinopathy, PDR)组Irisin的水平均明显低于对照组,MMP-9、VEGF水平均明显高于对照组(P＜0.05)。斯皮尔曼相关性分析得出,Irisin与MMP-9及 VEGF具有负相关关系(P＜0.05);Logisitic回归分析得出,Irisin、MMP-9及VEGF为DR危险因素。ROC曲线分析Irisin、MMP-9、VEGF三个因子联合诊断DR的价值高于单独因子的价值。结论：Irisin、MMP-9及VEGF参与 DR的病理过程,Irisin对于DR 有预测作用。
Objective:To investigate the predictive value of combined detection of serum irisin, matrix metalloproteinase 9 (MMP-9) and vascular endothelial growth factor (VEGF) for diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM). Methods: A total of 200 patients and healthy subjects who were hospitalized in the Inner Mongolia Autonomous Region People's Hospital from November 2022 to November 2023 were selected. According to the DR process, they were divided into four groups. Serum Irisin, MMP-9 and VEGF were detected by ELISA. Correlation analysis, ROC curve analysis and multiple regression analysis were performed. Results: The levels of irisin in type 2 diabetes mellitus without retinopathy (NDR) group, non-proliferative diabetic retinopathy (NPDR) group and proliferative diabetic retinopathy (PDR) group were significantly lower than those in the control group, and the levels of MMP-9 and VEGF were significantly higher than those in the control group, the difference were statistically significant (P＜0.05). Spearman correlation analysis showed that Irisin was negatively correlated with MMP-9 and VEGF (P＜0.05). Logistic regression analysis showed that Irisin, MMP-9 and VEGF were risk factors for DR. ROC curve analysis showed that the diagnostic value of Irisin, MMP-9 and VEGF in the diagnosis of DR was higher than that of single factor. Conclusion: Irisin, MMP-9 and VEGF are involved in the pathological process of DR, and Irisin has a predictive effect on DR.
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