D-二聚体与2型糖尿病周围神经病变相关性分析

Correlation between D-dimer and peripheral neuropathy in type 2 diabetes mellitus

目的分析D-二聚体(D-D)与2型糖尿病性周围神经病变(DPN)相关性。方法对2018年11月至2020年11月在郑州大学附属洛阳中心医院内分泌科住院符合条件的937例2型糖尿病(T2DM)患者进行回顾性横断面研究,根据有无DPN分为DPN组和无DPN组,并收集其一般资料及临床指标等,组间比较采用t检验,计数资料组间比较用卡方检验;通过统计学分析D-D与DPN相关性。结果无DPN组男367例,女253例,年龄(53.49±12.40)岁;DPN组男194例,女123例,年龄(58.02±10.88)岁。与无DPN组相比,DPN组更高龄(P=0.001),病程更长(P<0.001),更高的糖化血红蛋白(HbA1c)(P=0.012)、肌酐(Cr)(P<0.001)、低密度脂蛋白胆固醇(LDL-C)(P=0.024)、D-二聚体(D-D)(P<0.001),以及更高比例的高血压(P=0.013)。将单因素中有意义的指标纳入多因素logistic分析模型中,结果发现:DPN与年龄[比值比(OR):1.021,95%置信区间(CI):1.006~1.035,P=0.004]、DM病程(OR:1.029,95%CI:1.006~1.053,P=0.013)、HbA1c(OR:1.155,95%CI:1.063~1.256,P=0.001)、Cr(OR:1.009,95%CI:1.001~1.016,P=0.025)、LDL-C(OR:1.221,95%CI:1.049~1.422,P=0.010)、D-D(OR:1.001,95%CI:1.000~1.002,P=0.004)有关。结论D-D可能是DPN发生发展的危险因素。

Objective To explore the correlation between D-dimer(D-D)and type 2 diabetic peripheral neuropathy(DPN).Methods Nine hundred and thirty-seven eligible patients with type 2 diabetes mellitus(T2DM)hospitalized in Department of Endocrinology,Luoyang Central Hospital,Zhengzhou University from November 2018 to November 2020 were collected for the retrospective cross-sectional study.According to whether they had DPN,the patients were divided into a DPN group and a non-DPN group.Their general data and clinical indicators were collected.The t test was used for the comparison between groups,and the chi-square test was used for the comparison of count data between groups.The correlation between D-D and DPN was statistically analyzed.Results There were 367 males and 253 females in the non-DPN group,and they were(53.49±12.40)years old.There were 194 males and 123 females in the DPN group,and they were(58.02±10.88)years old.Compared with the non-DPN group,the DPN group were older(P=0.001),had a longer disease course(P<0.001),higher levels of glycosylated hemoglobin(HbA1c)(P=0.012),creatinine(Cr)(P<0.001),low density lipoprotein-cholesterol(LDL-C)(P=0.024),and D-dimer(D-D)(P<0.001),and a higher proportion of hypertension(P=0.013).The indicators with statistical differences were included into the multivariate logistic regression analysis model,and the results showed that DPN correlated with age(OR=1.021;95%CI 1.006-1.035;P=0.004),T2DM duration(OR=1.029;95%CI 1.006-1.053;P=0.013),HbA1c(OR=1.155;95%CI 1.063-1.256;P=0.001),Cr(OR=1.009;95%CI 1.001-1.016;P=0.025),LDL-C(OR=1.221;95%CI 1.049-1.422;P=0.010),and D-D(OR=1.001;95%CI 1.000-1.002;P=0.004).Conclusion D-D may be a risk factor for the development of DPN in patients with T2DM.