Predictive value of liver and kidney function and bone metabolism markers for postoperative outcomes in diabetic retinal surgery.

IF 1.6 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
American journal of translational research Pub Date : 2025-04-15 eCollection Date: 2025-01-01 DOI:10.62347/MDVM6037
Fang Zhang, Qianqian Zhai, Nana Wang, Zhanhui Zhu
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Abstract

Objective: This study aimed to explore liver and kidney function as well as bone metabolism in patients undergoing diabetic retinal surgery, and to evaluate their clinical significance in predicting postoperative outcomes.

Methods: A total of 150 patients (172 eyes) with proliferative diabetic retinopathy (PDR) who underwent retinal surgery were retrospectively analyzed and categorized into a vitrectomy group (n=78) and a photocoagulation group (n=72). Additionally, 50 healthy adults were included as the control group. Hepatic and renal function parameters, along with bone metabolism markers, were assessed before and after surgery. Logistic regression analysis was employed to evaluate their association with postoperative prognosis, while receiver operating characteristic (ROC) curves were used to assess the predictive performance of key indicators.

Results: Compared to the control group, patients with PDR showed significantly elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), urinary albumin-to-creatinine ratio (UACR), serum creatinine (Scr), and serum cystatin C (sCys-C), along with markedly reduced levels of glomerular filtration rate (GFR) and osteocalcin (all P < 0.05). When comparing treatment groups, the vitrectomy group exhibited a significantly higher overall improvement rate than the photocoagulation group (80.00% vs. 37.80%). Moreover, patients in the vitrectomy group demonstrated lower levels of AST, ALT, TBIL, UACR, Scr and sCys-C, and higher levels of GFR and osteocalcin (all P<0.05). Among all 150 surgical patients, the incidence of poor prognosis was 46.0%. Logistic regression analysis identified AST, ALT, TBIL, GFR, and surgical type as independent prognostic factors, irrespective of adjustment for confounding variables (P<0.05). ROC analysis showed that ALT and TBIL had moderate sensitivity (0.725 and 0.754, respectively), while AST and GFR exhibited high specificity (0.875 and 0.889, respectively) in predicting the prognosis of diabetic retinal surgery.

Conclusion: In diabetic patients undergoing retinal surgery, hepatic and renal function, along with bone metabolism, are significantly altered and appear to improve following surgical intervention. Specifically, levels of AST, ALT, TBIL, and GFR are closely associated with postoperative prognosis and may serve as valuable predictors of clinical outcomes.

肝肾功能及骨代谢指标对糖尿病视网膜手术术后预后的预测价值。
目的:本研究旨在探讨糖尿病视网膜手术患者肝肾功能及骨代谢的变化,并评价其对预测术后预后的临床意义。方法:回顾性分析行视网膜手术的增殖性糖尿病视网膜病变(PDR)患者150例(172只眼),分为玻璃体切除组(78只)和光凝组(72只)。另外,50名健康成人作为对照组。术前、术后评估肝肾功能参数及骨代谢指标。采用Logistic回归分析评价其与术后预后的相关性,采用受试者工作特征(ROC)曲线评价关键指标的预测效果。结果:与对照组相比,PDR患者的天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、总胆红素(TBIL)、尿白蛋白/肌酐比(UACR)、血清肌酐(Scr)、血清胱抑素C (sCys-C)水平显著升高,肾小球滤过率(GFR)、骨钙素水平显著降低(P < 0.05)。在治疗组比较中,玻璃体切割组的整体改善率明显高于光凝组(80.00%比37.80%)。此外,玻璃体切除术组患者AST、ALT、TBIL、UACR、Scr和sCys-C水平较低,GFR和骨钙素水平较高(均为ppr)。结论:在接受视网膜手术的糖尿病患者中,肝肾功能以及骨代谢在手术干预后明显改变并出现改善。具体而言,AST、ALT、TBIL和GFR水平与术后预后密切相关,可作为临床预后的有价值的预测指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American journal of translational research
American journal of translational research ONCOLOGY-MEDICINE, RESEARCH & EXPERIMENTAL
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