同型半胱氨酸、胱抑素C与糖尿病周围神经病变发病的相关性分析

Correlation Between Hcy,CysC and the Incidence of Diabetic Peripheral Neuropathy

目的探讨同型半胱氨酸(Hcy)、胱抑素C(CysC)与糖尿病周围神经病变(DPN)发病的相关性。方法2018年6月—2019年7月,符合T2DM标准收治的94例T2DM患者纳入研究,根据神经病变检测结果无病变的56例患者为单纯组,剩余38例患者为病变组,选择同一时间内55名健康体检者为正常组;分析三组基础资料,测定血清中Hcy、CysC水平。结果三组男女比例、年龄、BMI、DBP比较差异无统计学意义(P>0.05);病变组病程时间、HbA1c水平高于单纯组(P<0.05);HDL-C水平正常组高于单纯组和病变组(P<0.05),在其他指标中单纯组和病变组均高于正常组(P<0.05);单纯组Hcy、CysC水平分别为(11.65±2.63)μmol/L、(1.95±0.63)mg/L,高于正常组(8.75±2.80)μmol/L、(0.76±0.25)mg/L,且低于病变组Hcy、CysC水平(18.48±4.50)μmol/L、(2.95±1.24)mg/L,组间比较差异具有统计学意义(P<0.05)。血清中Hcy水平在DPN疾病发展与病程、HbA1c、LP(a)和CysC水平有相关性(P<0.05),与其余因素无关(P>0.05)。CysC水平在DPN疾病发展与患者病程、SBP、LP(a)和Hcy有相关性(P<0.05),与其余因素无关联(P>0.05)。以DPN为因变量,对T2DM患者中Hcy、CysC、HbA1c及病程进行Logistic回归分析,结果显示,Hcy、CysC、HbA1c及病程均是DPN患者病变的危险因素。结论Hcy、CysC与DPN患者病情严重度成正相关,并与患者病程、HbA1c、LP(a)有一定的相关性,可作为诊断DPN疾病的重要参考指标。

Objective To explore the correlation between Hcy,CysC and the pathogenesis of diabetic peripheral neuropathy(DPN).Methods From June 2018 to July 2019,94 patients with T2DM who met the T2DM criteria were selected.According to the detection results of neuropathy,56 patients without neuropathy were divided into simple group and the remaining 38 patients were lesion group.55 healthy people were selected at the same time as the normal group.The basic data of three groups were analyzed,and the levels of serum Hcy and CysC were detected.Results The ratio of men and women,age,BMI,and DBP in the three groups were not significant(P>0.05).The duration of disease and HbA1c level in the lesion group were higher than those in the simple group(P<0.05).The HDL-C was higher in the normal group than in the simple group and the lesion group(P<0.05).Among other indicators,the simple group and the lesion group were higher than the normal group(P<0.05).The levels of Hcy and CysC in the simple group[(11.65±2.63)μmol/L,(1.95±0.63)mg/L]were higher than those in the normal group[(8.75±2.80)μmol/L,(0.76±0.25)mg/L],and lower than those in the lesion group[(18.48±4.50)μmol/L,(2.95±1.24)mg/L].The differences between the groups were statistically significant(P<0.05).The level of serum Hcy in the development of DPN disease was correlated with the course of disease,HbA1c,LP(a),and CysC levels(P<0.05),and had no correlations with other factors(P>0.05).CysC levels in the development of DPN disease were related to the course of disease,SBP,LP(a)and Hcy(P<0.05),and had no correlations with other factors(P>0.05).With DPN as the dependent variable,Logistic regression analysis was performed on Hcy,CysC,HbA1c and the course of disease in T2DM patients.The results showed that Hcy,CysC,HbA1c and the course of disease were all risk factors for DPN patients.Conclusion Hcy and CysC are positively correlated with the severity of DPN patients,and have certain correlation with the course of disease,HbA1c,and LP(a),which can be used as important reference indicators for the diagnosis of DPN disease.