血清胰岛素样生长因子-Ⅱ与2型糖尿病外周神经病变的关系研究

Relationship between serum IGF-Ⅱand peripheral neuropathy in type 2 diabetics.

目的探讨胰岛素样生长因子-Ⅱ(IGF-Ⅱ)与2型糖尿病外周神经病变的关系。方法将2005年6月至2006年1月浙江大学医学院附属第一医院内分泌科收治的71例2型糖尿病非外周神经病变患者(A组)、77例2型糖尿病外周神经病变患者(B组)及30名健康对照者(C组)纳入研究,测定3组血清IGF-Ⅱ。A、B组加测静脉空腹血糖、胰岛素等相关临床指标及神经电生理检查。结果B组血清IGF-Ⅱ低于A组和C组,差异有显著性意义(P<0.05),C组和A组间血清IGF-Ⅱ差异无显著性意义(P>0.05);血清IGF-Ⅱ与神经传导速度呈正相关(P<0.05);血清IGF-Ⅱ是2型糖尿病外周神经病变的主要相关因素(P<0.05)。结论2型糖尿病外周神经病变患者血清IGF-Ⅱ明显下降,且IGF-Ⅱ降低与2型糖尿病外周神经病变的发生有关。

Objective To evaluate the possible relationship between IGF- Ⅱ and peripheral neuropathy in type 2 diabetes. Methods Seventy-one type 2 diabetic patients without peripheral neuropathy （Group A） , Seventy-seven patients with peripheral neuropathy （Group B ）and thiry healthy subjects （Group C ）were recruited. Serum IGF-Ⅱ was determined in all subjects. Other clinical parameters （ fasting plasma glucose, fasting plasma insulin, et al ） and nerve conduction velocity were determined in Group A and Group B. Results Group B had significantly lower levels of IGF- Ⅱ , compared to Grou- pA and Ⅲ（ P 〈 0. 05 ）. No significant difference was found between Group A and C ; the levels of serum IGF- Ⅱ were positively correlated with motor nerves conduction velocity and sensory nerves conduction velocity ; IGF- Ⅱ was independently related to peripheral neuropathy in type 2 diabetes. Conclusion Decreased IGF-Ⅱ in type 2 diabetic patients with peripheral neuropathy may contribute to the pathogenesis of neuropathy.