Study on the relationship between serum GPER1,SESN2 levels and diabetes retinopathy in patients with type 2 dia-betes

Zhang Wenjun; Cao Fang; Sun Yi; Bian Liming; Pu Yan

doi:10.3969/j.issn.1671-6450.2024.12.012

Abstract：Objective To study the relationship between serum G protein coupled estrogen receptor 1(GPER1),sestrin 2(SESN2)levels and diabetic retinopathy(DR)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 162 patients with T2DM diagnosed and treated in the 940 Hospital of Joint Logistics Support Force from February 2020 to February 2022 were retrospectively selected as the T2DM group.According to the results of eye examination,T2DM pa-tients were divided into DR subgroup(n=68)and non-DR subgroup(n=94).According to the severity of DR,DR patients were divided into proliferative subgroup(n=28)and non-proliferative subgroup(n=40).60 cases of healthy physical exami-nation in the same period were selected as the healthy control group.The levels of serum GPER1 and SESN2 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression analysis was used to analyze the influencing fac-tors of DR;the predictive value of serum GPER1 and SESN2 levels for DR was evaluated by receiver operating characteristic(ROC)curve.Results The serum GPER1 level in the retinopathy group was higher than that in the healthy control group,and the serum SESN2 level was lower than that in the healthy control group(t/P=36.850/＜0.001,28.112/＜0.001);the inci-dence of DR in 162 patients was 41.96％(68/162).The duration of diabetes,insulin resistance index(HOMA-IR)and serum GPER1 in DR subgroup were higher than those in non-DR subgroup,while glomerular filtration rate(eGFR)and serum SESN2 were lower than those in non-DR subgroup(t/P=1 1.552/＜0.001,3.078/0.009,17226/＜0.001,21.915/＜0.001,11.100/＜0.001).The serum GPER1 level in the proliferative DR subgroup was higher than that in the non-proliferative DR sub-group,and the serum SESN2 level was lower than that in the non-proliferative DR subgroup(t/P=12.151/＜0.001,3.534/＜0.001);Multivariate Logistic regression results showed that long duration of diabetes,high HOMA-IR and high GPER1 were independent risk factors for DR[OR(95％CI)=1237(1.096-1.397),1265(1.079-1.483),1347(1.054-1.721)],and high eGFR and SESN2 were independent protective factors for DR[OR(95％CI)=0.736(0.598-0.906),0.759(0.596-0.967)];The area un-der the curve(AUC)of serum GPER1,SESN2 levels and the combination of the two for predicting DR were 0.731,0.710 and 0.820,respectively.The AUC of the combination of the two was greater than that of serum GPER1 and SESN2 levels alone(Z=4.711,4.816,P＜0.001).Conclusion Serum GPER1 increases and SESN2 decreases in DR patients.Both of them are in-volved in the occurrence and development of DR.The combination of the two has a high predictive value for the occur-rence of DR.