Abstract / Summary
Background: To explore the relationships between serum silencing information regulator 4 (SIRT4), complement C1q tumour necrosis factor-related protein 5 (CTRP5), galectin-3 and glycolipid metabolism and prognosis in patients with diabetic retinopathy (DR).
Methods: The DR group was selected from among 115 hospitalised DR patients admitted between January 2023 and January 2024, including 61 non-proliferative DR patients (Non-proliferative DR group) and 54 proliferative DR patients (Proliferative DR group). Additionally, 50 subjects who underwent health check-ups in the hospital during the same period were selected as the control group. Indicators of SIRT4, CTRP5, galectin-3, blood glucose [Fasting plasma glucose (FPG)], and the levels of blood lipids in the DR group and the control group were measured and compared. Triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and total cholesterol (TC) were among them. Moreover, the correlations between serum SIRT4, CTRP5, and galectin-3 levels and blood glucose and lipid indicators in DR patients were analysed. The DR patients were monitored and followed up with for six months after treatment. Depending on their level of visual impairment, the patients were split into groups with excellent and poor prognoses. The levels of serum SIRT4, CTRP5 and galectin-3 in the two groups were compared. Multivariate logistic regression was used to analyse the risk factors for poor prognosis in DR patients. A receiver operating characteristic (ROC) curve was used to analyse the predictive value of single or combined detection of SIRT4, CTRP5, and galectin-3 for poor prognosis in patients with DR.
Results: Pearson correlation analysis revealed that the levels of SIRT4, CTRP5, and galectin-3 in DR patients were positively correlated with FPG, TG, TC, and LDL-C (P< 0.05) and negatively correlated with HDL-C (P< 0.05). The poor-prognosis group had higher serum levels of SIRT4, CTRP5, and galectin-3 than the good-prognosis group (P< 0.05). The poor prognosis group's DR course was longer than the excellent prognosis group's (P< 0.05), and the proportion of proliferative DR was greater than that in the good prognosis group (P< 0.05). DR course S6 months, SIRT4 S24 ng/mL, CTRP5 S8 ng/mL, galectin-3> 1,400 ng/mL, and DR stage of the proliferative type were all independent risk factors for poor prognosis in DR patients. The ROC curve analysis showed that the AUCs of each index for predicting a poor prognosis in DR patients were 0.796, 0.743, and 0.718, respectively, when the ideal cutoff values for the individual detection of serum SIRT4, CTRP5, and galectin-3 were 24 ng/mL, 8 ng/mL, and 400 pg/mL, respectively. Based on the results of the multivariate logistic regression analysis, a model with Ln(P/1-P) = 0.573 X X SIRT4 + 0.809 xX CTRP5 + 0.424xX Galectin-3 was established for the combined detection of the three indicators. The AUC of this model for predicting poor prognosis in DR patients was 0.833 (95% CI: 0.706-0.961), indicating a relatively high predictive value.