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Objective To investigate the influencing factors and bilirubin levels of diabetic retinopathy (DR) in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods T2DM patients who were hospitalized in the Department of Endocrinology from January to December 2021 in Xuanwu Hospital of Capital Medical University were retrospectively enrolled. All included patients underwent non-mydriatic fundus photography. The data of duration of diabetes, body mass index (BMI), creatinine, total bilirubin, direct bilirubin, indirect bilirubin, glycated hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (hs-CRP) and urinary albumin to creatinine ratio (UACR) were collected. The patients were divided into non-diabetic retinopathy (NDR) group and DR group according to the diagnostic and staging criteria of DR. The t-test, Mann-Whitney U test and χ2 test were used to compare the general clinical data between the two groups; multivariate logistic regression analysis was used to analyze the risk factors of DR. Results A total of 1 027 patients were enrolled, including 245 patients with DR and 782 patients with NDR. The prevalence of DR in hospitalized T2DM patients was approximately 23.9% (245/1 027). Compared with the NDR group, the DR group had a longer duration of diabetes, higher HbA1c, creatinine, UACR, hs-CRP levels, and lower total bilirubin, direct bilirubin and indirect bilirubin concentrations. The differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for gender, age and BMI, HbA1c (OR=1.199, 95%CI 1.112-1.293), duration of diabetes (OR=1.063, 95%CI 1.034-1.093), creatinine (OR=1.007, 95%CI 1.002-1.013), UACR (OR=1.389, 95%CI 1.280-1.507) and hs-CRP (OR=1.260, 95%CI 1.108-1.432) were the main risk factors for DR, total bilirubin (OR=0.927, 95%CI 0.873-0.983), direct bilirubin (OR=0.831, 95%CI 0.701-0.985) and indirect bilirubin (OR=0.898, 95%CI 0.825-0.976) were protective factors for DR; after further adjustment for HbA1c, diabetes duration (OR=1.063, 95%CI 1.033-1.093), creatinine (OR=1.008, 95%CI 1.002-1.013), UACR (OR=1.382, 95%CI 1.272-1.502) and hs-CRP (OR=1.214, 95%CI 1.065-1.384) were still independent risk factors for DR, total bilirubin (OR=0.922, 95%CI 0.867-0.980), direct bilirubin (OR=0.827, 95%CI 0.694-0.984) and indirect bilirubin (OR=0.889, 95%CI 0.815-0.969) were still protective factors for DR. Conclusion HbA1c, duration of diabetes, creatinine, UACR and hs-CRP are risk factors for DR, and bilirubin may be a protective factor for DR. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship between thyroid function and sarcopenia in Chinese geriatric patients with type 2 diabetes mellitus (T2DM). Methods Patients with T2DM aged over 60 years old were recruited from department of endocrinology, Xuanwu Hospital, Capital Medical University, from April 2017 to April 2019. Appendicular skeletal muscle mass, grip strength, and walking speed were measured, appendicular skeletal muscle mass index (ASMI) was calculated. Concentrations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were determined, FT3/FT4 ratio was calculated. Sarcopenia was defined based on the standard of the Asian Working Group of Sarcopenia. The included patients were divided into sarcopenia group and non-sarcopenia group. The t test or χ² test was used to compare general characteristics between the two groups; correlation analysis and multivariate logistic regression analysis were used to explore the relationship between thyroid function and sarcopenia. Results A total of 535 patients with T2DM aged over 60 years old were enrolled. There were 490 patients in sarcopenia group and 45 patients in non-sarcopenia group, respectively. Compared with non-sarcopenia patients, patients with sarcopenia demonstrated lower levels of FT3 and FT3/FT4 ratio (all P<0.05). In geriatric patients with T2DM, FT3/FT4 ratio was significant positively correlated with ASMI, grip strength and walking speed (r=0.240, 0.242 and 0.227, respectively, all P<0.01), the same with FT3 levels (r=0.300, 0.366 and 0.296, respectively, all P< 0.01). Multivariate logistic regression analysis showed that FT3/FT4 ratio (OR=0.396, 95%CI 0.158-0.992, P=0.048) was independent risk factor for sarcopenia. Conclusions In geriatric patients with T2DM, the concentrations of FT3 and FT3/FT4 ratio are significant positively correlated with the components of sarcopenia, and FT3/FT4 ratio is an independent predictor of sarcopenia. [ABSTRACT FROM AUTHOR]