中老年糖尿病患者血清胆红素水平和糖尿病周围神经病变的相关性研究

Association between serum bilirubin level and diabetic peripheral neuropathy in middle-aged and elderly patients with type 2 diabetes

目的探讨中老年糖尿病患者血清胆红素水平和糖尿病周围神经病变(DPN)的关系。方法选取728例中老年T2DM患者,根据双下肢肌电电生理检查分为非DPN组(NDPN组)和DPN组,分别测BMI、BP、FPG、FC-P、HbA_1c、肝肾功能、血脂、尿白蛋白/肌酐(UAlb/Cr)等指标,对各指标进行检验,并对DPN的危险因素行Logistic回归分析。结果 DPN组年龄、病程、HbA_1c、UAlb/Cr、Scr、TC、HDL-C、SUA、同型半胱氨酸(Hcy)高于NDPN组,而血清胆红素、白蛋白、γ-谷氨酰转肽酶(γ-GT)水平低于NDPN组(P<0.05或P<0.01)。Logistic回归分析显示,间接胆红素(IBIL)是DPN发生的危险因素,其水平随DPN严重程度的增加而降低。结论低血清IBIL水平是中老年糖尿病患者发生DPN的独立危险因素,其水平可能与DPN严重程度呈负相关。

Objective To investigate the association between serum bilirubin level and diabetic peripheral neuropathy（DPN） in middle-aged and elderly patients with type 2 diabetes （T2DM）. Methods 728 middle-aged and elderly patients with T2DM were selected and divided into two groups according to lower limbs nerve electrophysiological examination results：non-DPN （NDPN, n= 260） and DPN group （n = 468）. Body mass index （BMI）, blood pressure, fasting blood glucose, glycosylated hemoglobin（HbA1 c）, fasting C-peptide （FC-P）, liver and renal function, serum lipid and urinary albumin-to-creatinine ratio （UAlb/Cr） were detected and analyzed by Student＇s t test in both groups. Logistic regression analysis was used to obtain risk factors for DPN. Results Compared with NDPN group, age, duration of diabetes and the levels of UAlb/Cr, SUA, Scr,TC, HDL-C, HbAI c and Hcy in DPN group significantly increased, and the levels of serum bilirubin, albumin and 7-GT significantly decreased（P〈0. 05 or P〈0. 01）. Logistic analysis showed that IBIL level was negatively correlated with DPN . Conclusion In the middle-aged and elderly patients with T2DM, serum IBIL level is an independent risk factor for DPN and the level of IBIL is negatively correlated with the severity Of DPN.