血清铁蛋白与老年糖尿病患者周围神经病变的相关性研究

Correlation between serum ferritin and peripheral neuropathy in elderly diabetic patients

目的探讨老年糖尿病患者血清铁蛋白(SF)水平和糖尿病周围神经病变(DPN)的关系。方法选取2011年1月至2017年8月在芜湖市第二人民医院就诊的548例老年2型糖尿病(T2DM)患者,根据双下肢肌电图检查结果,分为非DPN组(NDPN组)与DPN组,NDPN组304例,DPN组244例,另选取同期健康体检者220例为对照组(NC组),分别检测3组研究对象体质指数(BMI)、血压(BP)、超氧化物岐化酶(SOD)、总胆固醇(TC)、三酰甘油(TG)、糖化血红蛋白(HbA1c)、内皮素(ET)、SF、一氧化氮(NO)等水平,DPN危险因素行logistic回归分析。结果除HDL-C水平外,DNP组、NDNP组和NC组各指标的差异均有统计学意义(P<0.05)。DPN组HbA1c、ET、TC、TG、LDL-C、SF水平高于NDPN组及NC组,而SOD、NO水平低于NDPN组及NC组,差异有统计学意义(P<0.05)。SF与HbA1c、TC、TG、ET均成正相关(r=0.613、0.461、0.542、0.583,P<0.05),与SOD、NO均成负相关(r=-0.432、-0.574,P<0.05)。logistic回归分析显示SF、ET是DPN的独立危险因素,而SOD、NO是DPN的保护性因素。结论 SF是老年T2DM患者DPN的独立危险因素,其可能通过氧化应激参与DPN的发展。

Objective To investigate the relationship betweenserum ferritin level and diabetic peripheral neuropathy（ DPN） in elderly patients with diabetesand the possible mechanism. Methods A total of 548 cases of elderly patients with T2DM from January 2011 to August 2017 in Wuhu Second People＇s Hospital were divided into non-DPN group（ NDPN group,n = 304） and DPN group（ n = 244） according to the double lower limb EMG. On the other hand,220 cases of healthy persons treated in the hospital during the same period were selected as control group（ NCgroup）. Body mass index（ BMI）,blood pressure（ BP）,orgotein superoxide dismutase（ SOD）,total cholesterol（ TC）,triglyceride（ TG）,endothelin（ ET）,serum ferritin（ SF）,glycated hemoglobin（ HbA1c） and nitric oxide（ NO） were measured and analysed,andthe potential risk factors for DPN were further calculated by Logistic regression analysis. Results Except for the HDL-C index,there were significant differences among the DNP,NDNP and NC groups（ P〈0. 05）. HbA1c,ET,TC,TG,LDL-C and SF were higher in DPN group than those in NDPN and NCgroup,while SOD and NO were lower than those in NDPN and NC group. There were statistically significant differences（ P〈0. 05; P〈0. 01）. The results of correlation analysis showed that SF was positively correlated with HbA1c,TC,TG and ET（ r = 0. 613,0. 461,0. 542,0. 583; P〈0. 05）. On the other hand,SF was negatively correlated with SOD and NO（ r =-0. 432,-0. 574; P〈0. 05）. Logistic regression analysis of DPN related factors showed that SF and ET were the independent risk factors of DPN,and that SOD and NO were the protective factors. Conclusion Serum ferritin is an independent risk factor for DPN in elderly diabetic patients,and it may be involved in the pathogenesis of DPN through oxidative stress.