血清MT、IGFBP3水平对年龄相关性白内障的诊断及预后评估价值

doi:10.3969/j.issn.1006-5725.2026.05.014

Abstract

Abstract:

Objective To investigate the diagnostic and prognostic value of serum melatonin （MT） and insulin-like growth factor binding protein 3 （IGFBP3） levels in patients with age-related cataract （ARC）. Methods This study enrolled 240 ARC patients who underwent surgery at our hospital from October 2023 to January 2025 as the ARC group， and 187 healthy individuals undergoing physical examinations during the same period as the control group. Serum MT and IGFBP3 levels were measured using enzyme-linked immunosorbent assay. Based on a 6-month postoperative follow-up， ARC patients were stratified into good and poor prognosis groups for prognostic factor analysis. Receiver operating characteristic （ROC） curves were used to evaluate the diagnostic and prognostic performance of serum MT， IGFBP3， and their combination. Results Compared with the control group， ARC patients exhibited significantly lower serum MT levels and higher IGFBP3 levels （P < 0.05）. For diagnosing ARC， the area under the ROC curve （AUC） was 0.817 for MT， 0.792 for IGFBP3， and 0.907 for their combination， with corresponding sensitivities of 76.67%， 60.00%， and 83.75%， and specificities of 73.80%， 85.03%， and 83.96%. The combined detection demonstrated superior diagnostic performance compared with either marker alone （P < 0.05）. The poor prognosis rate among ARC patients was 30.83% （74/240）. Multivariate logistic regression identified lens nuclear hardness grade Ⅳ—Ⅴ （OR = 4.632， 95%CI： 1.702 - 12.609， P = 0.003）， elevated intraocular pressure （OR = 1.341， 95%CI： 1.123 ~ 1.601， P = 0.001）， and increased IGFBP3 levels （OR = 1.001， 95%CI： 1.001 - 1.002， P < 0.001） as independent risk factors for poor prognosis. Conversely， greater subfoveal choroidal thickness （OR = 0.978， 95%CI： 0.964 - 0.991， P = 0.001） and higher MT levels （OR = 0.667， 95%CI： 0.577 - 0.771， P < 0.001） were independent protective factors. For prognostic evaluation， the AUCs were 0.836 for MT， 0.821 for IGFBP3， and 0.919 for their combination， with sensitivities of 58.11%， 91.89%， and 85.14%， and specificities of 92.77%， 54.82%， and 83.73%， respectively. The combined evaluation showed superior predictive value compared with either marker alone （P < 0.05）. Conclusion Decreased serum MT and elevated IGFBP3 levels are associated with ARC and its poor prognosis. The combined assessment of both biomarkers provides higher diagnostic accuracy and prognostic predictive value for ARC.

Key words: age-related cataract, melatonin, insulin-like growth factor binding protein 3, diagnosis, prognosis

CLC Number:

R776.1

Zhenggang WANG,Hui XIONG,Ting HE,Xiaojing LIU,Yanhua YE. Serum melatonin and IGFBP3 levels in the diagnosis and prognostic evaluation of age⁃related cataract[J]. The Journal of Practical Medicine, 2026, 42(5): 831-837.

Figures/Tables 7

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References 27

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组别	例数	MT（x ± s）	IGFBP3［M（P₂₅，P₇₅）］
ARC组	240	34.36 ± 5.38	5 044.34（3 898.12，6 132.26）
对照组	187	40.98 ± 5.25	3 509.50（2 255.11，4 438.88）
t/U值		-12.759	9 316.000
P值		< 0.001	< 0.001

指标	曲线下面积	95%CI	P值	截断值	敏感度/%	特异度/%	最大约登指数
MT	0.817	0.777 ~ 0.853	< 0.001	38.04 pg/mL	76.67	73.80	0.5046
IGFBP3	0.792	0.751 ~ 0.830	< 0.001	4 640.72 pg/mL	60.00	85.03	0.4503
二者联合	0.907	0.875 ~ 0.933	< 0.001	-^*	83.75	83.96	0.6771

项目	不良组（n = 74）	良好组（n = 166）	χ²/t/U值	P值
性别/例			0.669	0.413
男	43	87
女	31	79
年龄（x ± s）/岁	61.20 ± 5.89	60.05 ± 5.74	1.428	0.155
病程［M（P₂₅，P₇₅ ）］/个月	9.00（8.00，11.00）	9.00（7.00，10.00）	5 281.500	0.081
烟酒嗜好
吸烟史	35（47.30）	68（40.96）	0.838	0.360
饮酒史	22（29.73）	45（27.11）	0.175	0.676
类型			0.636	0.888
混合型	17（22.97）	33（19.88）
后囊下型	13（17.57）	26（15.66）
核性白内障	19（25.68）	49（29.52）
皮质性白内障	25（33.78）	58（34.94）
合并疾病
糖尿病	51（68.92）	101（60.84）	1.437	0.231
高血压	23（31.08）	48（28.92）	0.115	0.734
高脂血症	20（27.03）	33（19.88）	1.520	0.218
冠心病	26（35.14）	39（23.49）	3.512	0.061
晶状体核硬度			10.616	0.001
Ⅰ—Ⅲ级	32（43.24）	109（65.66）
Ⅳ—Ⅴ级	42（56.76）	57（34.34）
手术方式			6.660	0.010
白内障囊外摘除术	24（32.43）	29（17.47）
超声乳化白内障吸除术	50（67.57）	137（82.53）
BCVA（x ± s）/logMAR	0.62 ± 0.18	0.58 ± 0.15	1.791	0.075
眼压［M（P₂₅，P₇₅ ）］/mmHg	18.00（15.00，20.00）	17.00（14.00，19.00）	4 997.500	0.021
中央黄斑厚度（x ± s）/μm	251.05 ± 32.27	243.45 ± 26.84	1.902	0.058
CRT（x ± s）/μm	250.41 ± 27.84	242.05 ± 24.21	2.354	0.019
SFCT（x ± s）/μm	208.82 ± 40.15	233.26 ± 33.49	-4.902	< 0.001
MT（x ± s）/（pg/mL）	29.98 ± 4.61	36.31 ± 4.48	-10.002	< 0.001
IGFBP3［M（P₂₅，P₇₅ ）］/（pg/mL）	6 201.59（5 239.96，7 103.66）	4 428.44（3 519.66，5 568.27）	2 203.000	< 0.001

变量	P值	OR	95%CI
晶状体核硬度Ⅳ—Ⅴ级	0.003	4.632	1.702 ~ 12.609
白内障囊外摘除术	0.053	3.161	0.987 ~ 10.121
眼压升高	0.001	1.341	1.123 ~ 1.601
CRT增加	0.148	1.013	0.995 ~ 1.031
SFCT增加	0.001	0.978	0.964 ~ 0.991
MT升高	< 0.001	0.667	0.577 ~ 0.771
IGFBP3升高	< 0.001	1.001	1.001 ~ 1.002
常量	0.798	2.519	-

指标	曲线下面积	95%CI	P值	截断值	敏感度/%	特异度/%	最大约登指数
MT	0.836	0.783 ~ 0.880	< 0.001	30.25 pg/mL	58.11	92.77	0.508 8
IGFBP3	0.821	0.766 ~ 0.867	< 0.001	4 644.48 pg/mL	91.89	54.82	0.467 1
二者联合	0.919	0.877 ~ 0.951	< 0.001	-^*	85.14	83.73	0.688 7

Serum melatonin and IGFBP3 levels in the diagnosis and prognostic evaluation of age⁃related cataract

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