血清LDL与2型糖尿病周围神经病变的相关性研究

Correlation between serum LDL and peripheral neuropathy in type 2 diabetes

目的探讨分析血清低密度脂蛋白(low density lipoprotein,LDL)与2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的相关性。方法选择166例在2016年4月至2017年3月在我院接受治疗的2型糖尿病(type 2 diabetes mellitus,T2DM)患者,其中有94例T2DM患者无周围神经病变,纳入非DPN组,有72例T2DM患者周围神经病变,纳入DPN组,检测2组患者的血清LDL水平和相关的临床生化指标。结果经统计学分析DPN组患者的年龄、糖尿病病程、糖化血红蛋白(hemoglobin A1c,Hb A1c)、丙二醛(Malondialdehyde,MDA)和LDL水平显著高于非DPN组患者(P<0.05);DPN组患者的空腹C肽水平显著低于非DPN组患者(P<0.05);非DPN组、DPN组患者的性别、体重指数(body mass index,BMI)、血钙浓度、血磷浓度、尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、收缩压(systolic blood pressure,SBP)以及舒张压(diastolic blood pressure,DBP)无统计学差异(P>0.05)。通过Pearson相关分析发现血清LDL水平与患者糖尿病病程、Hb Alc、BMI和BUN呈正相关(P<0.05);与血钙水平、血磷水平、Scr水平和空腹C肽呈负相关(P<0.05);与患者的年龄、SBP和DBP(P>0.05)无关。以DPN为因变量,以患者的血清LDL、糖尿病病程、Hb Alc、BMI、BUN、血钙水平、血磷水平、Scr水平和空腹C肽为自变量,进行多因素Logistic逐步回归分析,发现LDL、Hb A1c与DPN呈正相关;空腹C肽与DPN呈负相关。结论本研究发现LDL、Hb A1c是2型糖尿病周围神经病变的相关因素,血清LDL水平与患者的糖脂代谢指标及相关生化指标密切相关,具有重要的临床意义。

Objective To investigate the correlation between serum low density lipoprotein(LDL)and diabetic peripheral neuropathy(DPN)in type 2 diabetes mellitus.Methods A total of 166 patients with type 2 diabetes mellitus(T2DM)who were treated in the First Affiliated Hospital of Hunan University of Chinese Medicine from April 2016 to March 2017 were enrolled.Among them,94 patients with T2DM had no peripheral neuropathy and were included in the non-DPN group,while peripheral neuropathy in 72 patients with T2DM was included in the DPN group.Serum LDL levels and related clinical biochemical parameters were measured in the 2 groups.Results The age,duration of diabetes,hemoglobin A1c(HbA1c),malondialdehyde(MDA)and LDL levels were significantly higher in the DPN group than in the non-DPN group(P<0.05).The fasting C-peptide level in the DPN group was significantly lower than that in the non-DPN group(P<0.05).There was no difference between non DPN and DPN groups of the gender,body mass index(BMI),blood calcium concentration,blood phosphorus concentration,urea nitrogen(BUN),serum creatinine(Scr),systolic blood pressure(SBP)and diastolic blood pressure(DBP)(P>0.05).Pearson correlation analysis showed that serum LDL levels were positively correlated with diabetes course,HbAlc,BMI and BUN(P<0.05),and negatively correlated with serum calcium levels,serum phosphorus levels,Scr levels,and fasting C-peptide(P<0.05)and not related to the patient??s age,SBP or DBP(P>0.05).Using DPN as the dependent variable and the patient??s serum LDL,diabetes course,HbAlc,BMI,BUN,blood calcium level,blood phosphorus level,Scr level and fasting C peptide as the independent variables,multivariate logistic stepwise regression analysis indicated that LDL and HbA1c were positively correlated with DPN,and fasting C peptide was negatively correlated with DPN.Conclusion This study demonstrated that LDL and HbA1c are related factors for the type 2 diabetic peripheral neuropathy.Serum LDL level is closely related to the glucose and lipid metabolism index and biochemical indicators of patients,and it has an important clinical significance.