目的：探讨血清circFTO、miR-141-3p水平变化与糖尿病视网膜病变患者不同疾病分期的关系。方法：选取2019-10/2022-11本院收治的198例2型糖尿病患者为研究对象，根据不同分期将患者分为非糖尿病视网膜病变(NDR)组70例、非增殖期糖尿病视网膜病变(NPDR)组66例、增殖期糖尿病视网膜病变(PDR)组62例； 同期选取67例本院体检正常的志愿者作为对照组。采用实时荧光定量PCR(qRT-PCR)法检测血清circFTO和miR-141-3p水平； 采用Pearson相关性分析检验糖尿病视网膜病变患者血清circFTO、miR-141-3p与各指标间的相关性； 采用多因素Logistic回归分析探讨糖尿病视网膜病变的影响因素。结果：PDR组circFTO、收缩压(SBP)、舒张压(DBP)高于对照组、NDR组、NPDR组，miR-141-3p、高密度脂蛋白胆固醇(HDL-C)低于对照组、NDR组、NPDR组(P<0.05)。NDR组、NPDR组、PDR组空腹血糖(FPG)、糖化血红蛋白(HbA1c)高于对照组(均P<0.05)。PDR组病程高于NDR组和NPDR组(P<0.05)。糖尿病视网膜病变患者血清circFTO与SBP、DBP、FPG、HbA1c呈正相关，miR-141-3p与SBP、DBP、FPG、HbA1c呈负相关(均P<0.05)。circFTO是影响糖尿病视网膜病变的危险因素，miR-141-3p是影响糖尿病视网膜病变的保护因素(P<0.05)。结论：糖尿病视网膜病变患者血清circFTO显著升高，miR-141-3p显著降低，二者均与疾病分期密切相关，有望成为评估疾病进展的重要指标。

AIM: To explore the relationship between the changes of serum circFTO and microRNA-141-3p(miR-141-3p)levels and the different disease stages of diabetes retinopathy.METHODS: A total of 198 patients with type 2 diabetes admitted to our hospital from October 2019 to November 2022 were collected as the study subjects, the patients were grouped into non diabetes retinopathy(NDR)group(70 cases), non proliferative diabetes retinopathy(NPDR)group(66 cases)and proliferative diabetes retinopathy(PDR)group(62 cases)according to different stages; meantime, 67 volunteers with normal physical examination results were collected as the control group. The levels of serum circFTO and miR-141-3p were detected by real-time fluorescent quantitative PCR(qRT-PCR); Pearson correlation analysis was used to examine the correlation between the serum circFTO, miR-141-3p and various indicators in patients with diabetes retinopathy; multivariate Logistic regression analysis was applied to explore the influencing factors of diabetes retinopathy.RESULTS: CircFTO, systolic blood pressure(SBP), and diastolic blood pressure(DBP)in PDR group were higher than those in control group, NDR group and NPDR group, while miR-141-3p and high-density lipoprotein cholesterol(HDL-C)were lower than those in control group, NDR group and NPDR group(P<0.05). Fasting blood glucose(FPG)and glycosylated hemoglobin(HbA1c)in NDR group, NPDR group and PDR group were higher than those in the control group(all P<0.05). The course of disease in PDR group was longer than that in NDR group and NPDR group(P<0.05). Serum circFTO in patients with diabetes retinopathy was positively correlated with SBP, DBP, FPG, HbA1c, and miR-141-3p was negatively correlated with SBP, DBP, FPG, HbA1c(all P<0.05). CircFTO was a risk factor for diabetes retinopathy, and miR-141-3p was a protective factor for diabetes retinopathy(P<0.05).CONCLUSION: Serum circFTO is obviously increased and miR-141-3p is obviously decreased in patients with diabetes retinopathy, both of them are closely related to disease stage, and are expected to become important indicators for evaluating disease progress.

湖南省临床医疗技术创新引导项目(No.2021SK50301); 湘南学院科学研究项目(No.2021XJ149)