目的：探究血清白细胞衍生趋化因子2(LECT2)、补体1q/肿瘤坏死因子相关蛋白5(CTRP5)与糖尿病视网膜病变(DR)的相关性研究。

方法：单中心横断面分析，纳入本院2023年4月至2025年4月收治的2型糖尿病(T2DM)患者138例，根据诊断结果分为无DR组60例和DR组78例，另将DR组分为增殖性DR(PDR)组29例、非增殖性DR(NPDR)组49例。Pearson法分析LECT2、CTRP5与糖脂代谢指标相关性，Logistic分析T2DM患者发生DR的影响因素； ROC曲线分析血清LECT2、CTRP5对T2DM患者发生DR的诊断价值。

结果：两组患者一般资料具有可比性。DR组血清LECT2、CTRP5、TC、TG、LDL-C、HOMA-IR水平较无DR组高，HDL-C较无DR组低(均P<0.05)。PDR组血清LECT2、CTRP5水平较NPDR组高(均P<0.05)。血清LECT2、CTRP5与TC、TG、LDL-C、HOMA-IR呈正相关，与HDL-C呈负相关(均P<0.001)。Logistic回归分析结果显示：糖尿病病程、TC、TG、LDL-C、HOMA-IR、LECT2、CTRP5为影响T2DM患者发生DR的危险因素(均P<0.05)。ROC曲线显示，血清LECT2、CTRP5单独及联合诊断T2DM患者发生DR的曲线下面积(AUC)为0.830、0.839、0.915，联合诊断的AUC经DeLong检验高于LECT2、CTRP5单独诊断效能(Z=2.818、2.824，P=0.015、0.012)。

结论：血清LECT2、CTRP5水平与T2DM患者发生DR具有密切关系，联合检测对诊断T2DM患者发生DR有一定临床价值。

METHODS:A single-center cross-sectional analysis was conducted on 138 patients with type 2 diabetes mellitus(T2DM)admitted to our hospital from April 2023 to April 2025. According to the diagnostic results, they were divided into a non-DR group(60 cases)and a DR group(78 cases). The DR group was further divided into a proliferative DR(PDR)group(29 cases)and a non-proliferative DR(NPDR)group(49 cases). Pearson correlation analysis was used to assess the correlation of LECT2 and CTRP5 with glucose-lipid metabolism indicators. Logistic regression analysis was conducted to identify the influencing factors for the occurrence of DR in T2DM patients. ROC curve analysis was performed to evaluate the diagnostic value of serum LECT2 and CTRP5 for DR in T2DM patients.

RESULTS: A comparison of general patient data between the two groups showed no significant differences. The DR group had higher serum levels of LECT2, CTRP5, total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), and homeostatic model assessment of insulin resistance(HOMA-IR)than the non-DR group, while high-density lipoprotein cholesterol(HDL-C)was lower(all P<0.05). The serum levels of LECT2 and CTRP5 in the PDR group were higher than those in the NPDR group(all P<0.05). Serum LECT2 and CTRP5 positively correlated with TC, TG, LDL-C, and HOMA-IR, and negatively correlated with HDL-C(all P<0.001). Logistic results showed that duration of diabetes, TC, TG, LDL-C, HOMA-IR, LECT2, and CTRP5 were risk factors for DR occurrence in T2DM patients(all P<0.05). The ROC curve showed that the AUCs for serum LECT2, CTRP5 alone, and combined in diagnosing DR in T2DM patients were 0.830, 0.839, and 0.915, respectively. The AUC for the combined diagnosis was higher than that of LECT2 or CTRP5 alone according to the DeLong test(Z=2.818, 2.824, P=0.015, 0.012).

CONCLUSION:Serum LECT2 and CTRP5 levels are closely related to the development of DR in T2DM patients, and joint detection has certain clinical value in diagnosing DR in T2DM patients.