2型糖尿病周围神经病变患者振动感觉阈值与25羟维生素D_3水平的相关性分析

Correlation analysis between vibrating perception threshold and serum 25-hydroxy vitamin D_3 in patients with type 2 diabetic peripheral neuropathy

目的探讨2型糖尿病(T2DM)周围神经病变(DPN)患者的振动感觉阈值与25羟维生素D_3[25(OH)D_3]水平的相关性。方法选取我院内分泌科2016年8月～2017年9月就诊的DPN患者180例,测定四肢末梢神经传导功能,根据振动感觉阈值的不同分为低风险组、中度风险组及重度风险组,每组各60例,记录三组的临床资料,分别测定空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂及25-OH-D_3,分析其相关性,同时以60例无合并周围神经病变的T2DM患者作为对照。结果低风险组的体重指数(BMI)、HbA1c、FPG、总胆固醇(TG)、三酰甘油(TC)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)与对照组比较,差异无统计学意义(P>0.05)。中度与重度风险组的BMI、HbA1c、FPG、TG、TC、LDL-C较低风险组及对照组均显著升高,而HDL-C显著降低,差异有统计学意义(P<0.05),中度与重度组BMI、HbA1c、FPG、TG、TC、HDL-C、LDL-C比较,差异无统计学意义(P>0.05)。三组不同振动感觉阈值组随着年龄的增加,病程延长,25(OH)D_3显著降低,差异有统计学意义(P<0.05)。Spearman相关分析结果显示,振动感觉阈值同25(OH)D_3成负相关(r=-0.494,P<0.05),年龄、病程、HbA1c与振动感觉阈值成正相关(r=0.461,r=0.569,r=0.648,P<0.05)。结论 25(OH)D_3的水平变化对DPN患者的振动感觉阈值有较大影响,T2DM患者适度补充25(OH)D_3可在某种程度上预防并改善DPN的发生。

Objective To investigate the correlation between vibrating perception threshold(VPT)and serum 25-hydroxy vitamin D3(25[OH]D3)in patients with type 2 diabetic peripheral Neuropathy(DPN).Methods A total of 180 patients with DPN in our hospital department of endocrinology from August 2016 to September 2017 were selected and divided into three groups according to the measurement of peripheral nerve conduction function and vibrating perception threshold,which were low risk group,medium risk group and severe risk group,60 cases in each group.The clinical data of all patients were collected and the fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),blood lipid and 25(OH)D3 were detected,the correlation of VPT with 25(OH)D3 was analyzed.A total of 60 cases of T2DM without peripheral neuropathy were taken as the control group.Results There were no significant differences in FPG,HbA1c,body mass index(BMI)and blood lipid in patients with vibration-sensing threshold in the low risk group compared with those in control group(P>0.05).The BMI,HbA1c,FPG,TG,TC,LDL-C of the moderate and severe risk groups were significantly increased,while high-density lipoprotein(HDL-C)was significantly decreased compared with those in low risk group and control group(P<0.05),while there was no significant difference between medium risk group and severe risk group(P>0.05).The 25(OH)D3 was significantly decreased in the 3 groups with the age increase and the course of disease was prolonged(P<0.05).Spearman correlation analysis showed that VPT was correlated negatively with 25(OH)D3(r=-0.494,P<0.05),but positively with age,course of disease,and HbA1c(r=0.461,r=0.569,r=0.648,P<0.05).Conclusion The change of 25(OH)D3 has a great influence on the VPT of DPN.Moderate supplementation of 25(OH)D3 in T2DM patients can prevent and improve the occurrence of DPN.