Objective To observe the serum betatrophin levels in patients with type 2 diabetes mellitus (T2DM) and to explore the role of betatrophin in the pathogenesis of diabetic retinopathy (DR). Methods A total of 59 patients with T2DM (DM group) and 14 healthy controls (NC group) were enrolled in the study. Vision, slit lamp microscope, indirect ophthalmoscope, fluorescein fundus angiography were performed on all the subjects. According to the results of the examination combined with the international DR clinical staging criteria, the patients were divided into no DR (Non-DR) group, non-proliferative DR (NPDR) group, and proliferative DR (PDR) group, with 30, 20 and 9 patients in each, respectively. The fasting blood glucose (FPG), insulin (FIN), C-peptide, glycated hemoglobin (HbA1c), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C), low-density lipid Protein (LDL-C) levels were detected. The level of betatrophin in serum was determined by enzyme-linked immunosorbent assay. The correlation between betatrophin and other indicators was analyzed by Spearman correlation. The influencing factors of PDR were analyzed by logistic regression. Results Compared with subjects in the NC group, the level of FPG (F=-4.316, P＜0.001), FIN (F=2.142, P=0.001), HbA1c (F=-5.726, P＜0.001), TC (t=3.609, P=0.010), LDL-C (t=0.000, P=0.003), and betatrophin (F=-2.263, P=0.024) were significantly increased and HDL-C level (F=-3.924, P＜0.001) was decreases in the DM group. The difference of TG level between two groups was not statistically significant (F= -1.422, P=0.155). Compared with the Non-DR group and the NPDR group, the serum C-peptide (F=7.818, P=0.020) and betatrophin levels (F=12.141, P=0.002) were significantly increased in the PDR group. Spearman correlation analysis showed that the levels of betatrophin in the DM group was positively correlated to TC (r=0.304, P=0.019). The serum levels of betatrophin was positively correlated to body mass index in the Non-DR group (r=0.513, P=0.004). Furthermore, in the PDR group, a significant positive correlation was observed between the serum betatrophin levels and diastolic blood pressure (r=0.685, P=0.042). Logistic regression analysis showed that the duration of diabetes, serum C-peptide and betatrophin levels were risk factors for PDR. After controlling for the duration and serum C-peptide, the PDR risk for betatrophin levels great than or equal to 1.0 ng/ml was 12 times as much as betatrophin levels less than 1.0 ng/ml in T2DM patients. Conclusions The serum betatrophin content of patients with T2DM is abnormal. Betatrophin may be involved in the occurrence and development of PDR.
ObjectiveTo observe the changes in visual field defect before and after treatment in patients with acute solitary occipital lobe cerebral infarction.MethodsFrom January 2017 to May 2019, 59 patients with hemianopsia who were diagnosed as acute occipital lobe cerebral infarction in Henan Provincial People's Hospital were selected. There were 35 males (59.3%) and 24 females (40.7%); aged from 50 to 72 years, with an average age of 62.86 ± 6.10 years. There were 23 patients of right occipital cerebral infarction and 36 patients of left occipital cerebral infarction. Lesions involved 41 patients in the striated area, 8 patients involved the occipital pole, and 23 patients involved visual radiation. All patients underwent standard medical treatment. All patients underwent visual field examination before treatment, and modified rankin scale (mRS) was used to evaluate the level of visual disability after cerebral infarction. At 1, 3, and 6 months after treatment, 54 patients underwent at least one visual field examination in outpatient or inpatient follow-up visits, and 5 patients were lost to follow-up; 49 patients received repeated mRS scores. The visual field defect and mRS score of patients before and after treatment were compared and analyzed. The improvement of visual field defect in the horizontal direction exceeding 10°or the vertical direction exceeding 15°was defined as improvement, otherwise it was defined as no improvement. According to the type of visual field defect, the patients were divided into two groups: complete homonymous hemianopia and incomplete homonymous hemianopia. The cumulative visual field improvement rate of the two groups of patients was calculated. An mRS score of 0 to 2 was defined as a good prognosis, and ＞2 was defined as a poor prognosis.ResultsBefore treatment, of the 59 patients, 47 were complete homonymous hemianopsia and 12 were incomplete. Of the 47 patients with complete homonymous hemianopia, 26 patients had hemianopia on the right side of both eyes, 21 patients had hemianopia on the left side of both eyes; 32 patients with macular avoidance (72.3%). Among the 12 patients of incomplete homonymous hemianopia, 10 patients of quadrant blindness included 6 patients of upper quadrant and 4 patients of lower quadrant; 2 patients of partial isotropic hemianopia on one side. Of the 54 patients reviewed after treatment, the visual field improved at the last follow-up of 25 patients (46.3%), and there was no improvement in 29 patients (53.7%). The cumulative visual field improvement rate of 47 patients with complete hemianopia hemianopia before treatment was 37.2% (16/43). The cumulative visual field improvement rate of 11 patients with incomplete isotropic hemianopia before treatment was 81.8% (9/11). There was a statistically significant difference in cumulative visual field improvement between the two groups of patients (χ2 = 7.011, P＜0.05). Before treatment, 59 patients had mRS scores of 1 to 2 points in 15 patients (25.4%), and 44 patients with 2 points or more (74.6%). Of the 49 patients reviewed after treatment, 28 (57.1%) had a good prognosis and 21 (42.9%) had a poor prognosis.ConclusionsThe visual field defect of patients with homonymous hemianopsia after acute occipital infarction may be improved after treatment. The improvement mostly occurs within 1 m after treatment, and patients with incomplete homonymous hemianopsia have more significant improvements than those with complete homonymous hemianopsia.