二十二碳六烯酸与糖尿病视网膜病变的关联性

doi:10.3760/cma.j.cn115909-20191017-00281

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Abstract Objective: To investigate the association of docosahexaenoic acid (DHA) with the presence of diabetic retinopathy (DR). Methods: This was a multiple-center, hospital-based, case-control study. A total of 197 type 2 diabetes mellitus (T2D) patients aged no less than 35 years old were enrolled from two affiliated hospitals of Wenzhou Medical University and Anhui Medical University. Depending on the fundus photos, they were classified into T2D (controls) and T2D combined with DR (cases). Based on propensity score matching, at a ratio of 1:1, by age, sex, body mass index and glycated hemoglobin, 69 pairs of cases and controls were included in the final data analysis. The intensity of DHA was determined using the ultraperformance liquid chromatography-electrospray ionization-tandem mass spectrometry (UPLC-ESI-MS/ MS) system. Multiple locally weighted regression and conditional logistic regression models were applied to comprehensively assess the association between DHA and the presence of DR. In addition, the results of a heterogeneity test and the interaction of DHA and the subgroups were displayed by a forest map. Results: A total of 69 pairs of cases and controls were included in the present study. The intensity of DHA in the cases was significantly lower than that of the controls (t=3.68, P=0.001). After adjusting for potential confounding factors including age, triglyceride, hypertension and diabetes duration, the prevalence of DR was significantly reduced by 53% (odds ratio: 0.47; 95% confidence interval: 0.30, 0.73) with a per interquartile range elevation of DHA. As is shown in the forest map, associations of DHA with the odds of DR were consistent in each subgroup and no interaction effects between the subgroups and DHA were observed. Conclusions: DHA is an independent protective factor of DR and significantly associated with its initiation and progression. Our findings emphasize the clinical and public policy relevance of early screening for DR as well as its secondary prevention, which perhaps should be confirmed by additional large, longitudinal studies.

Key words： docosahexaenoic acid diabetic retinopathy diabetes propensity score matching

Received: 17 October 2019

Fund:Zhejiang Basic Public Welfare Research Project (LGF19H260011); Wenzhou Basic Public Welfare Research Project (Y20180201); Initial Scientific Research Fund of the Eye Hospital of Wenzhou Medical University (KYQD170301); Academician's Science and Technology Innovation Program in Zhejiang Province (2018R413182).

Corresponding Authors: Guangyun Mao, Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou 325027, China; Department of Preventive Medicine, School of Public Health & Management, Wenzhou Medical University, Wenzhou 325035, China (Email: mgy@wmu.edu.cn)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20191017-00281 OR https://www.cjoovs.com/EN/Y2020/V22/I6/401

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