皮肤自发荧光(SAF)与中国2型糖尿病患者周围神经病变(DPN)的相关性

The association between skin autofluorescence (SAF) and diabetic peripheral neuropathy (DPN) in Chinese patients with type 2 diabetes mellitus

目的在中国汉族2型糖尿病患者中探讨皮肤自发荧光(skin autofluorescence,SAF)与糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)之间的关系。方法2015年12月至2016年6月从上海市静安区医联体慢病管理库中纳入资料完整的115名2型糖尿病患者。所有纳入者均进行SAF检查及神经传导功能检查(nerve conduction studies,NCS),并根据NCS的检查结果分为DPN组和非DPN组。结果115名2型糖尿病患者中,DPN组39人,非DPN组76人。DPN组SAF测量值为(2.67±0.45)AU,显著高于非DPN组的( 2.28 ±0.41)AU( P <0.001)。根据SAF测量值的第25百分位数和第75百分位数将所有纳入者分为低、中、高SAF组,NCS检查参数包括运动神经传导速度、感觉神经传导速度、远端潜伏期和感觉神经动作电位波幅,3组间差异有统计学意义( P <0.05)。Logistic回归分析显示,SAF为DPN的独立危险因素(OR=8.947,95%CI:1.675~47.793, P =0.010)。ROC曲线显示SAF诊断DPN的曲线下面积为0.726 (95%CI:0.630~0.821, P < 0.001 )。结论SAF为DPN的独立危险因素,对中国汉族2型糖尿患者中DPN患病风险筛查可能存在一定的价值。

Objective To evaluate the association between skin autofluorescence (SAF) and diabetic peripheral neuropathy (DPN) in Chinese Han nationality patients diagnosed with type 2 diabetes mellitus. Methods In this study,115 patients with type 2 diabetic were enrolled from 5 community health centers in Jing’an District of Shanghai between Dec.,2015 and Jun.,2016.SAF and nerve conduction studies (NCS) were performed in all the patients.All patients were diagnosed with DPN or non-DPN according to the results of NCS. Results Among the 115 patients,39 were DPN and 76 were non-DPN. Compared with non-DPN group, DPN group had higher SAF [(2.67±0.45) AU vs.(2.28±0.41) AU]( P <0.001).All the patients were divided into 3 groups according to tertiles of SAF.Some NCS parameters including motor nerve conduction velocity (MNCV),sensory nerve conduction velocity (SNCV),distal latency (DL) and sensory nerve action potential (SNAP),had significant differences among the 3 groups of SAF ( P <0.05).In Logistic regression,the presence of DPN was independently associated with SAF (OR=8.947,95%CI:1.675-47.793, P =0.010).ROC curves illustrated that the area under ROC curve of SAF was up to 0.726 (95% CI:0.630-0.821, P < 0.001) for DPN diagnosis. Conclusions The presence of DPN is independently associated with a higher SAF in Han Chinese with type 2 diabetes mellitus,and this non-invasive measurement of SAF may have a value for screening the risks of DPN in Chinese patients with diabetes.