Efficacy Analysis of Combined Detection of Angiotensin Ⅱ,Endothelin,and Nitric Oxide in the Diagnosis of Latent Diabetic Optic Neuropathy in Patients with Type 2 Diabetes Mellitus

ZONG Zhifeng; KANG Lili; ZHANG Gang; YAO Qingqing; ZHAI Xiaoyu

doi:10.3969/j.issn.1002-3429.2025.11.007

Abstract：Objective To explore the diagnostic value of combined detection of angiotensin Ⅱ(AngⅡ),endothelin,and nitric oxide for latent diabetic optic neuropathy(DON)in patients with type 2 diabetes mellitus(T2DM).Methods Clinical data of 500 patients with T2DM admitted from April 2020 to April 2024 were retrospectively analyzed.Patients were divided into the DON group(n=44)and the non-DON group(n=456)based on the presence or absence of latent DON.The baseline data and levels of AngⅡ,endothelin,and nitric oxide were compared between the two groups.Multivariate logistic regression analysis was used to identify the influencing factors of latent DON occurrence.Receiver operating characteristic(ROC)curves,clinical impact curves,and decision curves were employed to evaluate the efficacy,actual concordance rate,and clinical utility of the combined detection of AngⅡ,endothelin,and nitric oxide in the diagnosis of latent DON.Results Patients in the DON group had a longer duration of diabetes than those in the non-DON group,with higher levels of fasting blood glucose,glycosylated hemoglobin,AngⅡ,and endothelin,and lower levels of nitric oxide than the non-DON group(P<0.01).Multivariate logistic regression analysis showed that AngⅡ,endothelin,and nitric oxide were all influencing factors for the occurrence of latent DON(P<0.01).The area under the ROC curve(AUC)of AngⅡ,endothelin,and nitric oxide in the diagnosis of latent DON was 0.843,0.777,and 0.835,respectively,indicating a certain diagnostic efficacy.The combination of AngⅡ,endothelin,and nitric oxide had the largest AUC for diagnosing latent DON,at 0.939,with a sensitivity of 84.09%and a specificity of 90.57%.The results of the combination of Ang Ⅱ,endothelin,and nitric oxide in diagnosing latent DON had a high concordance rate with the actual situation,and the combination of Ang Ⅱ,endothelin,and nitric oxide had a significant positive net benefit,demonstrating good clinical efficacy.Conclusion Conclusion Patients with latent DON exhibit abnormal levels of AngⅡ,endothelin,and nitric oxide,which can serve as diagnostic markers.The combined detection of these three markers enhances diagnostic efficacy and provides a basis for early clinical monitoring of DON occurrence.