内源分泌型晚期糖基化终末产物受体与糖尿病周围神经病变的相关性

Plasma endogenous secrection receptor for advanced glycation end products of type 2 diabetes patients is associated with diabetic peripheral neuropathy

目的 探讨2型糖尿病患者周围神经病变(DPN)与内源分泌型晚期糖基化终末产物受体(esRAGE)的关系.方法 收集2008年6月至2009年3月于福建医科大学第二医院内分泌科住院的2型糖尿病患者61例及门诊体检的健康志愿者24名,根据有无合并糖尿病周围神经病变将糖尿病患者分2组,DPN组62例,无DPN组19例.采用酶联免疫吸附法(ELISA)测定血浆esRAGE水平.应用肌电诱发电位仪进行神经功能检查.测定受试者血压、体重指数、空腹血糖、糖化血红蛋白(HbA1c)、血脂.采用student t检验和非参数Mann-Whitney U检验分析两组问数据,利用Logistic回归分析糖尿病周围神经病变的相关因素.结果 正常对照组和2型糖尿病组患者血浆esRAGE水平无明显差别[(0.28±0.13)μg/L和(0.25±0.15)μg/L,P＞0.05],但在2型糖尿病患者中合并DPN组和无合并DPN组之间血浆esRAGE水平差别有显著性意义[(0.21±0.14)μg/L和(0.33±0.13)μg/L,P＜0.01],两组之间的年龄和糖化血红蛋白(HbA1c)也存在差别,Logistic回归分析提示年龄、HbA1c、血浆esRAGE水平与糖尿病周围神经病变相关,esRAGE是糖尿病周围神经病变保护因素(OR=0.001,P＜0.05).结论 2型糖尿病患者血浆esRAGE水平和正常人无明显差别.esRAGE是2型糖尿病周围神经病变的保护因素,而年龄和HbAlc是其危险因素.

Objective To compare the plasma endogenous secrection receptor for advanced glycation end products (esRAGE) level between normal subjects and type 2 diabetes mellitus (T2DM) patients,and to investigate whether the esRAGE is associated with diabetic peripheral neuropathy in T2DM patients.Methods A total of 24 cases of normal subjects and 61 cases of T2DM patients were involved in the study,and then the patients were divided into two groups,that was,patients with diabetic peripheral neuropathy (DPN) group and without diabetic peripheral neuropathy (non-DPN) group.Plasma esRAGE was measured with Enzyme linked immunosorbent assay (ELISA).Myoelectricity evoked potential equipment was applied to detect nerve conduction studies.Blood pressure,body mass index,fasting plasma glucose,HbA1c,and plasma lipids level were measured as well.Student t test and nonparametric statistics were applied to analysis data between two groups and the related factors of DPN were investigated with logistic regression analysis.Results The plasma esRAGE level did not show significant difference between normal subjects and T2DM patients ((0.28±0.13) μg/L vs (0.25±0.15) μg/L,P＞0.05).However there was significant different between DPN group and non-DPN group in patients ((0.21±0.14) μg/L vs (0.33±0.13) μg/L,P＜0.05).The logistic regression analysis showed DPN was associated with age,HbA1c,and esRAGE in T2DM patients.Conclusions The plasma esRAGE level has not significant difference between T2DM patients and normal subjects.The plasma esRAGE level is a protective factor for DPN,on the contrary age and HbA1c are risk factors for DPN in T2DM patients.