方法：共374例研究对象纳入本研究，包括88例增殖性糖尿病性视网膜病变患者(PDR)、124例非增殖性糖尿病性视网膜病变患者(NPDR)、78例无视网膜病变的糖尿病患者(DR)和84例健康对照志愿者(对照组)。收集人口学资料、体检及实验室指标，ELISA方法测定血清总脂联素和高分子量脂联素水平。统计学分析方法包括协方差分析和累积logit模型。

结果：对照组的总脂联素水平高于其他三组(修正均数：5.717、3.310、3.288、3.822 ug/ml， F=18.792，P<0.01)，PDR组的总脂联素水平高于NPDR组(P<0.05)。对照组的高分子量脂联素水平高于其他三组(修正均数：2.490、1.425、1.409、1.633 ug/ml，F=14.025，P<0.01)，其他三组的高分子量脂联素水平的差异无统计学意义(P>0.05)。高分子量脂联素与总脂联素的比值在四组间的差异无统计学意义(F=0.650，P>0.05)。服药史、高水平的高密度脂蛋白胆固醇、总脂联素和高分子量脂联素是NPDR的保护性因素，年老、糖尿病病程长、肿瘤坏死因子-α升高是NPDR的独立危险因素。

结论：较低浓度的血清总脂联素和高分子量脂联素水平可能参与非增殖性糖尿病性视网膜病变的发生，总脂联素水平可能与糖尿病性视网膜病变的严重程度有关。

METHODS:Three hundred and seventy-four subjects were recruited from an epidemiological survey, including 88 patients with proliferative diabetic retinopathy, 124 patients with non-proliferative diabetic retinopathy, 78 patients only with type 2 diabetes mellitus and 84 healthy volunteers. Demographics, physical and laboratory parameters were collected. Serum total and HMW adiponectin levels were detected by ELISA. The main statistical analysis included covariance analysis and cumulative logit model.

RESULTS:Total adiponectin level was higher in healthy group than in groups of only diabetes, non-proliferative and proliferative diabetic retinopathy(harmonic mean, 5.717, 3.310, 3.288, 3.822 μg/ml, F=18.792, P<0.01). Total adiponectin in proliferative diabetic retinopathy increased compared with non-proliferative diabetic retinopathy(harmonic mean, 3.822, 3.288 ug/ml, P<0.05). HMW adiponectin level of healthy group is more than other groups(harmonic mean, 2.490, 1.425, 1.409, 1.633 μg/ml, F=14.025, P<0.01). HMW adiponectin among only type 2 diabetes mellitus, non-proliferative and proliferative diabetic retinopathy groups had no differences(P>0.05). The ratio of HMW adiponectin and total adiponectin had no differences among four groups(F=0.650, P>0.05). Drug history, high levels of high density lipoprotein cholesterol, total and HMW adiponectin had protective effects to the non-proliferative diabetic retinopathy(P<0.05). Older age, long duration of diabetes, high level of tumor necrosis factor-α(TNF-α)were independent risk factors.

CONCLUSION:The lower concentrations of serum total and HMW adiponectin may result in the occurrence of non-proliferative diabetic retinopathy. And the total adiponectin level was related to the severity of diabetic retinopathy.