Abstract：Objective To examine the associations between three adipokines (omentin-1, nesfatin-1 and apelin) and diabetic retinopathy (DR) among patients with type 2 diabetes mellitus (T2DM), so as to provide the basis for the prevention and control of DR. Methods The T2DM patients hospitalized in Lishui TCM Hospital from August 2021 to May 2023 were selected and divided into three groups: no diabetic retinopathy (NDR) group, non-proliferative diabetic retinopathy (NPDR) group, and proliferative diabetic retinopathy (PDR) group based on fundus fluorescein angiography. Data on gender, age, and course of T2DM were collected through questionnaires, and serum omentin-1, nesfatin-1, apelin, and related blood biochemical indicators were measured. The associations of omentin-1, nesfatin-1 and apelin with DR were analyzed using a multinomial logistic regression model. Results A total of 150 T2DM patients were enrolled, including 58 cases in the NDR group, 60 cases in the NPDR group, and 32 cases in the PDR group, with males accounting for 60.34%, 45.00% and 68.75%, respectively. The mean ages were (54.79±14.40), (57.03±12.20) and (57.72±10.70) years, respectively. The median (interquartile range) courses of T2DM were 7.00 (7.75), 10.00 (8.00) and 10.00 (5.00) years, respectively. Compared with the NDR group, the NPDR group had lower levels of omentin-1 and nesfatin-1 and higher level of apelin, while the PDR group had higher level of omentin-1 and lower level of apelin (all P<0.05). Compared with the NPDR group, the PDR group had higher levels of omentin-1 and nesfatin-1 and lower level of apelin (all P<0.05). Multinomial logistic regression analysis showed that omentin-1 level was statistically associated with NPDR (OR=0.503, 95%CI: 0.291-0.871) and PDR (OR=7.862, 95%CI: 2.956-20.910); nesfatin-1 (OR=0.971, 95%CI: 0.953-0.989) and apelin (OR=3.266, 95%CI: 1.817-5.868) levels were statistically associated with NPDR. Conclusion Serum levels of omentin-1, nesfatin-1 and apelin were associated with different stages of DR among T2DM patients.
孙霞, 但玲英, 郑鹏, 陈薪伊. 2型糖尿病患者脂肪因子与糖尿病视网膜病变的关联研究[J]. 预防医学, 2025, 37(3): 248-252.
SUN Xia, DAN lingying, ZHENG Peng, CHEN Xinyi. Associations of adipokine with diabetic retinopathy among patients with type 2 diabetes mellitus. Preventive Medicine, 2025, 37(3): 248-252.
[1] TEO Z L,THAM Y C,YU M,et al.Global prevalence of diabetic retinopathy and projection of burden through 2045:systematic review and meta-analysis[J].Ophthalmology,2021,128(11):1580-1591. [2] DUH E J,SUN J K,STITT A W.Diabetic retinopathy:current understanding,mechanisms,and treatment strategies[J/OL].JCI Insight,2017,2(14)[2025-02-05].https://doi.org/10.1172/jci.insight.93751. [3] 柏旭,苏洁,李凤,等. 我国成人糖尿病视网膜病变影响因素的Meta分析[J]. 预防医学,2023,35(7):595-601. BAI X,SU J,LI F,et al.Factors affecting diabetic retinopathy among Chinese adults:a meta-analysis[J]. China Prev Med J,2023,35(7):595-601.(in Chinese) [4] LEANDRO A,QUEIROZ M,AZUL L,et al.Omentin:a novel therapeutic approach for the treatment of endothelial dysfunction in type 2 diabetes[J].Free Radic Biol Med,2021,162:233-242. [5] DONG J,XU H,XU H,et al.Nesfatin-1 stimulates fatty-acid oxidation by activating AMP-activated protein kinase in STZ-induced type 2 diabetic mice[J/OL].PLoS One,2013,8(12)[2025-02-05].https://doi.org/10.1371/journal.pone.0083397. [6] WANG X,ZHANG L,LI P S,et al.Apelin/APJ system in inflammation[J/OL].Int Immunopharmacol,2022,109[2025-02-05].https://doi.org/10.1016/j.intimp.2022.108822. [7] ALBERTI K G,ZIMMET P Z.Definition,diagnosis and classification of diabetes mellitus and its complications. Part 1:diagnosis and classification of diabetes mellitus provisional report of a WHO consultation[J].Diabet Med,1998,15(7):539-553. [8] CATURANO A,D'ANGELO M,MORMONE A,et al.Oxidative stress in type 2 diabetes:impacts from pathogenesis to lifestyle modifications[J].Curr Issues Mol Biol,2023,45(8):6651-6666. [9] UNAMUNO X,GOMEZ-AMBROSI J,RODRIGUEZ A,et al.Adipokine dysregulation and adipose tissue inflammation in human obesity[J/OL].Eur J Clin Invest,2018,48(9)[2025-02-05].https://doi.org/10.1111/eci.12997. [10] 姜佳佳,李峰,房冬冬,等. 2型糖尿病患者非增殖型糖尿病性视网膜病变的影响因素分析[J]. 预防医学,2023,35(1):17-20. JIANG J J,LI F,FANG D D,et al.Factors affecting the risk of non-proliferative diabetic retinopathy among patients with type 2 diabetic mellitus[J]. China Prev Med J,2023,35(1):17-20.(in Chinese) [11] YANG R Z,XU A H,PRAY J,et al.Cloning of omentin,a new adipocytokine from omental fat tissue in humans[J].Diabetes,2005,52(Suppl. 1):1-674. [12] YASIR M,SENTHILKUMAR G P,JAYASHREE K,et al.Association of serum omentin-1,apelin and chemerin concentrations with the presence and severity of diabetic retinopathy in type 2 diabetes mellitus patients[J].Arch Physiol Biochem,2022,128(2):313-320. [13] 郭毅飞,李雪锋,曾玉琴,等.糖尿病患者血清瘦素、脂联素水平与糖尿病视网膜病变不同分期的相关性研究[J].临床和实验医学杂志,2019,18(1):43-46. GUO Y F,LI X F,ZENG Y Q,et al.Correlation of serum leptin and adiponectin with diabetic retinopathy staging[J].J Clin Exp Med,2019,18(1):43-46.(in Chinese) [14] SUN H Y,ZHAO H H,YAN Z P,et al.Protective role and molecular mechanism of action of nesfatin-1 against high glucose-induced inflammation,oxidative stress and apoptosis in retinal epithelial cells[J/OL].Exp Ther Med,2021,22(2)[2025-02-05].https://doi.org/10.3892/etm.2021.10265. [15] DAI R F,DENG G H,SUN Z,et al.Relation of serum and vitreous nesfatin-1 concentrations with diabetic retinopathy[J/OL].J Clin Lab Anal,2017,31(5)[2025-02-05].https://doi.org/10.1002/jcla.22105. [16] CHENG J,LUO X L,HUANG Z,et al.Apelin/APJ system:a potential therapeutic target for endothelial dysfunction-related diseases[J].J Cell Physiol,2019,234(8):12149-12160. [17] JIANG Y H,FAN H Y,XIE J,et al.Association between adipocytokines and diabetic retinopathy:a systematic review and meta-analysis[J/OL].Front Endocrinol,2023,14[2025-02-05].https://doi.org/10.3389/fendo.2023.1271027. [18] FENG J,YANG W Q,LUAN F X,et al.The protective role of apelin in the early stages of diabetic retinopathy[J/OL].Int J Mol Sci,2022[2025-02-05].https://doi.org/10.3390/ijms232314680. [19] LU Q,MA Y,XU Y S,et al.Apelin in epiretinal membranes of patients with proliferative diabetic retinopathy[J].Mol Vis,2014,20:1122-1131. [20] LI Y,HU Q R,WANG B.Effects of apelin on the fibrosis of retinal tissues and müller cells in diabetes retinopathy through the JAK2/STAT3 signalling pathway[J/OL].Autoimmunity,2023,56[2025-02-05].https://doi.org/10.1080/08916934.2023.2259129.
