目的：探讨血浆胰岛素水平与屈光发育的相关性。

方法：收集2019-01/06在我院眼科检查的11～12岁青少年293例，根据屈光度分为正视组(76例)、低、中度近视组(144例)、高度近视组(35例)、远视组(38例)。测定并比较四组受检者空腹及餐后2h血浆胰岛素及其相关指标(血糖、糖化血红蛋白、C肽)水平，分析血浆胰岛素及其相关指标与屈光度的相关性，并采用受试者工作特性(ROC)曲线探讨血浆胰岛素水平对屈光发育异常的诊断价值。

结果：低、中度近视组、高度近视组空腹或餐后2h胰岛素、血糖、糖化血红蛋白、C肽的平均水平均高于正视组、远视组，且高度近视组胰岛素、血糖、糖化血红蛋白含量高于低、中度近视组(均P<0.01)。餐后2h血浆胰岛素、血糖、糖化血红蛋白、C肽水平与屈光度均呈负相关(r=-0.691、-0.756、-0.546、-0.311，均P<0.05)。ROC曲线显示，餐后2h血浆胰岛素水平鉴别屈光不正的截断值为0.367，最大曲线下面积为0.708(P<0.001，95%CI：0.576～0.840)，敏感性为63%，特异性为73.7%。

结论：血浆胰岛素水平升高可能影响屈光发育，其水平越高近视程度越高。因此，在生长期经常高糖碳水化合物饮食可能会导致屈光不正的发展及永久性视力损伤。

METHODS: Collected 293 adolescents aged 11-12 who were examined in our hospital from January to June 2019.According to the refractive power, they were divided into emmetropia group(76 cases), low and moderate myopia group(144 cases), high myopia group(35 cases), and hyperopia group(38 cases). Measure and compare the plasma insulin and related indexes(blood sugar, glycosylated hemoglobin, C-peptide levels)of the four groups of subjects on an empty stomach and 2h after a meal. Person correlation was used to analyze the correlation between plasma insulin and its related indexes and diopter. The receiver operating characteristic(ROC)curve was used to explore the diagnostic value of plasma insulin levels for refractive dysplasia.

RESULTS: The average levels of insulin, blood glucose, glycosylated hemoglobin, and C-peptide in the low and moderate myopia group and the high myopia group on an empty stomach or 2h after a meal were higher than those in the emmetropia group and the hyperopia group. The levels of insulin, blood sugar and glycosylated hemoglobin in the high myopia group were higher than those in the low and moderate myopia group(all P<0.01). Plasma insulin, blood glucose, glycosylated hemoglobin, and C peptide levels were negatively correlated with diopter 2h after a meal(r=-0.691, -0.756, -0.546, -0.311, all P<0.05). The ROC curve showed that the cut-off value of plasma insulin level 2h after meal for identifying refractive errors was 0.367, the maximum area under the curve was 0.708(P<0.001, 95% CI: 0.576-0.840), the sensitivity was 63%, and the specificity was 73.7%.

CONCLUSION: Elevated plasma insulin level may affect refractive development, the higher the level, the higher the degree of myopia. Therefore, regular high-glycemic carbohydrate diets during the growth period may lead to the development of refractive errors and permanent visual impairment.