ABSTRACT
AIM: To investigate the relationship among the fasting plasma glucose coefficient of variation(FPG-CV)and macular morphology and microcirculation in patients with nonproliferative diabetic retinopathy(NPDR).METHODS: A retrospective analysis of 82 cases(82 eyes)with NPDR admitted to our hospital from February 2018 to June 2022 was the research object, and another 82 cases(82 eyes)of non-diabetic retinopathy(NDR)patients during the same period were selected as the control group, and the clinical data of the two groups of patients were analyzed. Multivariate Logistic regression was used to analyze the risk factors affecting the incidence of NPDR, and the back propagation(BP)neural network model was established and evaluated. Pearson correlation was used to analyze the correlation among FPG-CV and macular morphology and microcirculation in patients. RESULTS: The results of multivariate Logistic regression analysis showed that the disease duration ≥7.2a, glycated hemoglobin A1c(HbA1c)≥7.7%, triglyceride(TG)≥1.9 mmol/L, microalbuminuria(MALB)≥24.5 mg/L, FPG-CV ≥9.8%, superficial capillary plexus-vessel density(SCP-VD)<27.6%, deep capillary plexus-vessel density(DCP-VD)<47.7%, foveal avascular zone(FAZ)area ≥0.38 mm2, central retinal thickness(CRT)≥197.7 μm and subfoveal choroidal thickness(SFCT)<227.7 μm were risk factors for NPDR(P<0.05). The number of hidden layer nodes is 5, and the receiver operating characteristic(ROC)curve, calibration curve and clinical decision curve show that the prediction model has good discrimination, accuracy and validity. The results of Pearson correlation analysis showed that FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT(P<0.05); FPG-CV was positively correlated with FAZ area and CRT(P<0.05).CONCLUSION: The course of disease, HbA1c, TG, MALB, FPG-CV, SCP-VD, DCP-VD, FAZ area, CRT and SFCT are all related to the pathogenesis of NPDR. With the increase of FPG-CV, the indexes of macular morphology and microcirculation changed. FPG-CV was negatively correlated with SCP-VD, DCP-VD and SFCT and positively correlated with FAZ area and CRT.
ABSTRACT
<p><b>OBJECTIVE</b>To study the function of pancreatic islet beta cells, insulin resistance (IR) and features of TCM symptoms and syndromes in the non-diabetic first-grade relatives (ND1GR) of patients with type 2 diabetes mellitus (DM2).</p><p><b>METHODS</b>A total of 68 ND1GR of DM2 patients were enrolled in the observed group and 45 healthy subjects with matched sex, age and body mass index (BMI) but without family history of DM were selected into the control group. Levels of fasting blood glucose (FBG), 2 hrs postprandial glucose (2hPG), fasting insulin (FINS) and 2 hrs postprandial insulin (2h INS) in all the subjects were measured to calculate and compare the IR and beta-cell function of the homeostatic model analog (HOMA-IR and HOMA-beta), and the insulin sensitive index (ISI). Moreover, the symptoms manifested in the ND1GR were also observed to analyze the features in them.</p><p><b>RESULTS</b>FBG and FINS were obviously higher in the observed group than those in the control group (P < 0.01), while no significant difference was found in 2hPG or 2h INS (P > 0.05). HOMA-IR and HOMA-beta were significantly higher (P < 0.05) and ISI were significantly lower (P < 0.01) in the observed group than those in the control group. Compared with the control group, the main symptoms such as dark purplish tongue, listlessness, thready and thin pulse, lassitude in loin and legs in the observed group were seen more frequently. In the observed group syndrome of deficiency of Qi and Yin accounted for 51.47%, syndrome of deficiency of Yin for 30.88%, subjects with syndrome of blood stasis as the main accompanying syndrome accounts for 61.76%.</p><p><b>CONCLUSION</b>Higher beta cell secretion function and lower insulin sensitivity appear in ND1GR of DM2 patients, suggesting the existence of insulin resistance. The feature of TCM syndrome in them is characterized by deficiency of Qi and Yin with inner obstruction of blood stasis.</p>