The value of serum AG and GPIHBP1 levels in the diagnosis and evaluation of diabetic retinopathy

Liu Yanjun; Ma Donghui; Zhang Yaping; He Xiaoyi; Zhao Huanlao

doi:10.3969/j.issn.1671-6450.2026.02.002

Abstract：Objective To investigate the efficacy of serum acylated ghrelin(AG)and glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1(GPIHBP1)levels in the evaluation of diabetic retinopathy(DR)and pro-liferative DR(PDR).Methods A total of 338 patients with type 2 diabetes mellitus(T2DM)admitted to the Department of Endocrinology,987th Hospital of Joint Logistics Support Force from January 2022 to February 2025 were selected as the T2DM group,and 60 healthy individuals during the same period were selected as the control group.Based on the occurrence and development of DR,T2DM patients were divided into a PDR subgroup(62 cases),a non-proliferative DR(NPDR)sub-group(73 cases),and a non-DR(NDR)subgroup(203 cases).Serum AG and GPIHBP1 levels were detected by enzyme-linked immunosorbent assay.Multivariate logistic regression analysis was used to analyze the relationship between serum AG and GPIHBP1 levels and the occurrence and development of DR and PDR.Receiver operating characteristic(ROC)curve analysis was used to evaluate the efficacy of serum AG and GPIHBP1 levels in the assessment of DR and PDR.Results Compared with the control group,serum AG levels were lower and GPIHBP1 levels were higher in the T2DM group(t/P=-9.398/＜0.001,12.221/＜0.001).Serum AG levels decreased sequentially,and GPIHBP1 levels increased sequentially,across the NDR,NPDR,and PDR subgroups(F/P=58.552/＜0.001,75.813/＜0.001).Multivariate logistic regression analysis showed that a longer duration of T2DM,higher glycated hemoglobin,and higher GPIHBP1 levels were independent risk fac-tors for the occurrence and development of DR and PDR[OR(95％CI)=1.902(1.482-2.442),1.741(1.361-2.228),6.111(1.790-20.861),2.842(1.012-7.979),1.010(1.004-1.016),1.007(1.002-1.012)],while higher AG levels were an independ-ent protective factor[OR(95％CI)=0.962(0.929-0.996),0.965(0.936-0.995)].ROC curve analysis showed that the area un-der the curve(AUC)for serum AG,GPIHBP1 levels,and their combination in evaluating DR were 0.790,0.816,and 0.897,respectively.The combined evaluation was superior to either marker alone(Z/P=5.442/＜0.001,4.779/＜0.001).The AUC for serum AG,GPIHBP1 levels,and their combination in evaluating PDR were 0.784,0.796,and 0.865,respectively.The com-bined evaluation was superior to either marker alone(Z/P=3.945/＜0.001,3.200/0.001).Conclusion Decreased serum AG levels and increased GPIHBP1 levels are closely associated with the occurrence and development of DR.The combination of serum AG and GPIHBP1 levels has high efficacy in evaluating the occurrence and development of DR.