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目的探讨谷氨酰转肽酶(GGT)对2型糖尿病视网膜病变发生危险的影响。方法选取2009年1月至2011年12月在河北省秦皇岛市中医院住院及门诊的132例2型糖尿病伴视网膜病变患者和137例不伴有视网膜病变的2型糖尿病患者进行病例对照研究。比较2组常规临床参数、生化指标及GGT、铁蛋白水平的差异,对于差异有统计学意义的指标进一步行Logistic回归分析,寻找糖尿病视网膜病变的独立危险因素。结果单变量分析结果显示,2组间体质量指数、糖尿病病程、糖化血红蛋白(HbA1c)、甘油三酯(TG)、GGT和铁蛋白水平差异有统计学意义。随着GGT水平的升高,不同程度的糖尿病视网膜病变(DR)患病率呈升高趋势。多因素Logistic回归分析显示:GGT[OR=3.259,95%CI(1.399,7.592)]、TG[OR=4.271,95%CI(2.148,8.491)]、糖尿病病程[OR=1.969,95%CI(1.127,3.439)]及HbA1c[OR=2.397,95%CI(1.394,4.124)]是糖尿病视网膜病变的独立危险因素。GGT与不同程度DR均有相关性。结论 GGT是糖尿病视网膜病变发生的危险因素,其临床应用价值尚需前瞻性的研究进一步证实。
Objective To investigate the effect of glutamyl transpeptidase (GGT) on the risk of type 2 diabetic retinopathy. Methods A retrospective case-control study was conducted in 132 patients with type 2 diabetic retinopathy and 137 type 2 diabetic patients without retinopathy hospitalized and outpatient in Qinhuangdao Chinese Medicine Hospital from January 2009 to December 2011. Logistic regression analysis was used to compare the two groups of routine clinical parameters, biochemical parameters and GGT, ferritin levels, to find the independent risk factors for diabetic retinopathy. Results The results of univariate analysis showed that body mass index, duration of diabetes, HbA1c, triglyceride (TG), GGT and ferritin levels were significantly different between the two groups. With the increase of GGT level, the prevalence of diabetic retinopathy (DR) is increasing. Multivariate Logistic regression analysis showed that GGT [OR = 3.259,95% CI (1.399,7.592)], TG [OR = 4.271,95% CI 2.148,8.491], duration of diabetes [OR = 1.969,95% CI 1.127,3.439)] and HbA1c [OR = 2.397,95% CI (1.394,4.124)] were independent risk factors for diabetic retinopathy. GGT with varying degrees of DR are related. Conclusions GGT is a risk factor for diabetic retinopathy. Its clinical value needs to be further confirmed by prospective study.