目的：探讨纤维凝胶蛋白-3(Ficolin-3)、分泌型卷曲相关蛋白5(SFRP5)在2型糖尿病(T2DM)合并糖尿病视网膜病变(DR)患者血清中的表达及其诊断价值。

方法：前瞻性选取本院2023年5月至2025年5月收治的T2DM合并DR患者，根据DR严重程度分为非增殖型组和增殖型组。另选取同期单纯T2DM患者作为T2DM组； 采用ELISA检测Ficolin-3、SFRP5水平； Pearson法分析T2DM合并DR患者血清Ficolin-3、SFRP5水平和炎性指标的相关性； 采用Logistic分析相关影响因素； ROC曲线分析血清Ficolin-3、SFRP5对T2DM合并DR患者的诊断价值。

结果：本研究共纳入T2DM合并DR患者108例(非增殖型组57例，增殖型组51例)，T2DM组108例。非增殖型组年龄59.01±6.28岁，男34例，女23例。增殖型组59.09±6.35岁，男30例，女21例。T2DM组58.96±6.18岁，男62例，女46例。非增殖型组、增殖型组血清Ficolin-3、TNF-α、IL-6水平高于T2DM组(均P<0.05)，SFRP5水平低于T2DM组(均P<0.05)，增殖型组血清Ficolin-3、TNF-α、IL-6水平高于非增殖型组(均P<0.05)，SFRP5水平低于非增殖型组(P<0.05)。Pearson相关性显示，血清Ficolin-3与SFRP5呈负相关(P<0.05)，二者与TNF-α、IL-6相关(均P<0.001)。Logistic分析显示，糖尿病病程、SUA、HbA1c、Ficolin-3、TNF-α、IL-6为T2DM合并DR患者的危险因素(均P<0.05)，SFRP5为保护因素(P<0.05)。ROC曲线得知，血清Ficolin-3、SFRP5单独及联合诊断T2DM并发DR患者的AUC为0.774、0.793、0.864，联合诊断的AUC优于单独诊断(Z=2.694、2.708，均P<0.05)。

结论：T2DM合并DR患者血清中Ficolin-3、SFRP5水平异常表达，二者均是T2DM合并DR的影响因素，联合检测可提高对T2DM合并DR患者的诊断价值。

METHODS: Prospectively selected patients with T2DM combined with DR admitted to the hospital from May 2023 to May 2025 were divided into non-proliferative and proliferative groups according to the severity of DR. Another patients with T2DM alone during the same period were selected as the T2DM group. ELISA was used to detect Ficolin-3 and SFRP5 levels; Correlation of serum Ficolin-3, SFRP5 levels, and inflammatory markers in T2DM patients with DR were analyzed using Pearson method; Logistic regression was used to analyze related influencing factors; ROC curve analysis was used to evaluate the diagnostic value of serum Ficolin-3 and SFRP5 for DR in T2DM patients.

RESULTS: This study included a total of 108 patients with T2DM combined with DR(57 cases in the non-proliferative group, 51 cases in the proliferative group)and 108 cases in the T2DM group. The non-proliferative group had an average age of 59.01±6.28 y, with 34 males and 23 females. The proliferative group had an average age of 59.09±6.35 y, with 30 males and 21 females. The T2DM group had an average age of 58.96±6.18 y, with 62 males and 46 females.The serum levels of Ficolin-3, TNF-α, and IL-6 in the non-proliferative and proliferative groups were higher than those in the T2DM group(all P<0.05), while the level of SFRP5 was lower than that in the T2DM group(all P<0.05). The serum levels of Ficolin-3, TNF-α, and IL-6 in the proliferative group were higher than those in the non-proliferative group(all P<0.05), and the level of SFRP5 was lower than that in the non-proliferative group(P<0.05).Complying with Pearson correlation analysis showed that serum Ficolin-3 was negatively correlated with SFRP5(P<0.05), and both were related to TNF-α and IL-6(all P<0.001). Logistic analysis showed that the course of diabetes, SUA, HbA1c, Ficolin-3, TNF-α, and IL-6 were the risk factors for T2DM patients with DR(all P<0.05), and SFRP5 was a protective factor(P<0.05). Complying with the ROC curve, the AUC values of serum Ficolin-3 and SFRP5 alone and their combination for diagnosing T2DM patients with DR were 0.774, 0.793, and 0.864, respectively. The AUC of combined diagnosis was better than that of single diagnosis(Z=2.694, Z=2.708, both P<0.05).

CONCLUSION: In patients with T2DM complicated by DR, serum levels of Ficolin-3 and SFRP5 are abnormally expressed. Both are influencing factors for T2DM with DR, and the combined detection can improve the diagnostic value in these patients.