血清Ficolin-3与S100B在糖尿病周围神经病变中的临床意义

Clinical significance of serum Ficolin-3 and S100B in diabetic peripheral neuropathy

目的探讨血清纤维凝胶蛋白-3(Ficolin-3)与S100B在糖尿病周围神经病变(DPN)中的临床意义。方法选取2019年1月—2020年2月在我院接受治疗的2型糖尿病患者126例,其中单纯2型糖尿病患者(糖尿病组)68例,2型糖尿病合并DPN患者(神经病变组)58例;另选取同期在我院体检的健康人群40例作为对照组。收集3组患者临床资料、生化指标及糖尿病患者正中神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV),采用酶联免疫吸附法(ELISA)检测血清Ficolin-3、S100B的水平。比较3组研究对象临床特征的差异,分析2型糖尿病患者并发DPN的危险因素以及DPN患者血清Ficolin-3、S100B与临床指标的相关性,受试者工作特征(ROC)曲线分析血清Ficolin-3与S100B对DPN的辅助诊断价值。结果神经病变组的收缩压(SBP)、空腹血糖(FBG)、稳态模型评估胰岛素抵抗指数(HOMA-IR)、超敏C反应蛋白(hs-CRP)、S100B水平高于糖尿病组和对照组,Ficolin-3水平低于糖尿病组和对照组(P<0.05)。多因素Logistic回归分析显示,hs-CRP≥2.1 mg/L、MNCV≤50 m/s、SNCV≤47 m/s、S100B≥200 ng/L是2型糖尿病患者并发DPN的危险因素(P<0.05),而Ficolin-3≥22μg/L则是DPN的保护因素(P<0.05)。相关性分析显示血清Ficolin-3与S100B呈负相关(r=-0.338,P<0.05)。ROC曲线分析显示,血清Ficolin-3(AUC=0.747)与S100B(AUC=0.734)均对DPN有诊断价值。联合应用时诊断价值进一步提升(AUC=0.819)。结论血清Ficolin-3与S100B均在DPN中呈异常表达,两者对DPN均有一定的辅助诊断价值。

Objective To investigate the clinical significance and diagnostic value of serum fibrin-3(Ficolin-3)and S100B in diabetic peripheral neuropathy(DPN).Methods A total of 126 patients with type 2 diabetes who were treated in our hospital from January 2019 to February 2020 were selected in this study.Sixty-eight patients with simple type 2 diabetes were included in the diabetes group,and 58 patients with type 2 diabetes complicated with DPN were included in the neuropathy group.In addition,40 healthy people who were examined in our hospital during the same period were selected as the control group.The clinical data,biochemical indexes,motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of median nerve were collected in the three groups of patients.Enzyme-linked immunosorbent assay(ELISA)was used to detect the levels of serum Ficolin-3 and S100B.The clinical characteristics of study objects in the three groups were compared.The risk factors of type 2 diabetes patients complicated with DPN and the correlation between serum Ficolin-3,S100B and clinical indexes were analyzed.Receiver operating characteristic(ROC)curve was used to analyze the auxiliary diagnostic value of serum Ficolin-3 and S100B for DPN.Results The levels of systolic blood pressure(SBP),fasting blood glucose(FBG),homeostasis model assessment of insulin resistance index(HOMA-IR),high sensitivity C-reactive protein(hs-CRP)and S100B were significantly higher in neuropathy group than those in diabetes group and control group,and the level of Ficolin-3 was significantly lower than that in diabetes group and control group(P<0.05).Multivariate Logistic regression analysis showed that the level of hs-CRP≥2.1 mg/L,the level of MNCV≤50 m/s,the level of SNCV≤47 m/s and the level of S100B≥200 ng/L were the risk factors for type 2 diabetes patients complicated with DPN(P<0.05),and the level of Ficolin-3≥22μg/L was the protective factor for type 2 diabetes patients complicated with DPN(P<0.05).Correlation analysis showed that serum ficolin-3 was negatively correlated with S100B(r=-0.338,P<0.05).ROC curve analysis showed that the serum Ficolin-3(AUC=0.747)and S100B(AUC=0.734)had diagnostic values for DPN.The diagnostic value of combined application was further improved(AUC=0.819).Conclusion The serum Ficolin-3 and S100B are expressed abnormally in DPN,and both of them have certain auxiliary diagnostic values for DPN.