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已发表论文
2 型糖尿病患者血红蛋白水平与增殖性糖尿病视网膜病变的关系
Authors Ding Y , Hou Z, Mei M, Wu K, Tao L, Yang G
Received 4 August 2025
Accepted for publication 18 November 2025
Published 3 December 2025 Volume 2025:18 Pages 4439—4447
DOI https://doi.org/10.2147/DMSO.S556952
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Rebecca Baqiyyah Conway
Yu Ding,1,2 Zhengyu Hou,1 Mei Mei,1 Kaifeng Wu,1 Liming Tao,2 Guoke Yang1
1Department of Ophthalmology, The First People’s Hospital of Hefei, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230032, People’s Republic of China; 2Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, People’s Republic of China
Correspondence: Guoke Yang, Email ahhf9020@foxmail.com
Introduction: Diabetic retinopathy (DR), particularly proliferative diabetic retinopathy (PDR), is a leading cause of blindness. This study aimed to evaluate the predictive value of hemoglobin (Hb) and direct bilirubin (DBil) for PDR progression.
Methods: We retrospectively collected data from 1,496 T2DM patients with DR treated at the South District of the First People’s Hospital of Hefei. Logistic regression, correlation analysis, restricted cubic spline models, and Mendelian randomization were used.
Results: For each unit increase in Hb and DBil, the risk of PDR decreased by 4.4% and 29.1%, respectively. Restricted cubic spline analyses showed a non-linear association between Hb and PDR: the risk decreased with increasing Hb up to a turning point at approximately 133 g/L and then plateaued thereafter; a turning point of 2.67 μmol/L was identified for DBil. The combined diagnostic model of Hb and DBil yielded an AUC of 0.742 with sensitivity 54.5% and specificity 86.5%, indicating moderate discriminative ability. Subgroup analysis showed higher PDR prevalence with worsening anemia. Mendelian randomization suggested a possible association between genetically predicted anemia and higher PDR risk (OR 1.06, 95% CI 1.003– 1.12).
Conclusion: Lower Hb and DBil levels were associated with higher PDR prevalence in this hospitalized population. These findings reflect statistical associations and require confirmation in prospective, population-based studies.
Keywords: type 2 diabetes, diabetic retinopathy, proliferative diabetic retinopathy, hemoglobin, direct bilirubin
1Department of Ophthalmology, The First People’s Hospital of Hefei, The Third Affiliated Hospital of Anhui Medical University, Hefei, 230032, People’s Republic of China; 2Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, People’s Republic of China
Correspondence: Guoke Yang, Email ahhf9020@foxmail.com
Introduction: Diabetic retinopathy (DR), particularly proliferative diabetic retinopathy (PDR), is a leading cause of blindness. This study aimed to evaluate the predictive value of hemoglobin (Hb) and direct bilirubin (DBil) for PDR progression.
Methods: We retrospectively collected data from 1,496 T2DM patients with DR treated at the South District of the First People’s Hospital of Hefei. Logistic regression, correlation analysis, restricted cubic spline models, and Mendelian randomization were used.
Results: For each unit increase in Hb and DBil, the risk of PDR decreased by 4.4% and 29.1%, respectively. Restricted cubic spline analyses showed a non-linear association between Hb and PDR: the risk decreased with increasing Hb up to a turning point at approximately 133 g/L and then plateaued thereafter; a turning point of 2.67 μmol/L was identified for DBil. The combined diagnostic model of Hb and DBil yielded an AUC of 0.742 with sensitivity 54.5% and specificity 86.5%, indicating moderate discriminative ability. Subgroup analysis showed higher PDR prevalence with worsening anemia. Mendelian randomization suggested a possible association between genetically predicted anemia and higher PDR risk (OR 1.06, 95% CI 1.003– 1.12).
Conclusion: Lower Hb and DBil levels were associated with higher PDR prevalence in this hospitalized population. These findings reflect statistical associations and require confirmation in prospective, population-based studies.
Keywords: type 2 diabetes, diabetic retinopathy, proliferative diabetic retinopathy, hemoglobin, direct bilirubin