2型糖尿病足部振动感觉损伤相关危险因素分析

Analysis of risk factors related to decreased feet vibration perception in type 2 diabetic patients

目的研究2型糖尿病足部振动感觉损伤相关危险因素。方法用振动感觉分析仪对3270名2型糖尿病患者行振动感觉检查，分为振动感觉减退的研究组及无振动感觉减退的对照组，测定尿蛋白、血脂、体重指数、血糖、HbA1c、血清果糖胺、C肽、血压等及眼底检查。结果研究组年龄平均为（59±12）岁，病程≥5年、24h尿蛋白定量≥300mg／d、有糖尿病视网膜病变、足部症状及男性比例均高于对照组，空腹血清C肽（0．56±0．45）nmol／L、餐后2hC肽（1．81±0．95）nmol／L均低于对照组[（0．65±0．56）和（2．14±0．82）nmol／L，P〈0．05]。Logistic回归分析显示，足部症状、24h尿蛋白定量、糖尿病病程与振动感觉减退明显相关。结论24h尿蛋白量、糖尿病病程、足部症状是2型糖尿病振动感觉损伤的危险因素。

Objective To study the risk factors of decreased feet vibration perception in type 2 diabetic patients. Methods Three thousand two hundred and seventy patients with type 2 diabetes were divided into 2 groups according to the results of vibration perception test ： group A with decreased vibration perception and grnup B with normal perception as control. Urinary protein content, lipid profile, body mass index, blood glucose, HbA, c, plasma fructosamine, C-peptide, and blood pressure were measured, and ocular fundus were examined. Results The subjects in group A were older than those in group B [ （59± 12） vs （56±12） years,P〈0.05 ]. The percentage of longer diabetes duration （ ≥5 years） ,24 h urinary protein content ≥300 mg/d, combined diabetic retinopathy, foot symptoms and male sex were higher in group A than those in group B. Fasting and postprandial C- peptide levels [ （ 0.56±0.45 and 1.81 ±0.95 ） nmol/L] in group A were lower than those in group B [ （0.65±0.56 and 2.14±0. 82） nmol/L, P〈0. 05 ]. Logistic regression analysis showed that the independent risk factors of decreased feet vibration perception in type 2 diabetic patients were 24 h urinary protein, foot symptoms and duration of diabetes. Conclusion 24 h urinary protein content,duration of diabetes, and foot symptoms seem to be the most important risk factors related to decreased vibration perception in type 2 diabetes.