2型糖尿病患者超敏C反应蛋白、胰岛素样生长因子⁃1及低密度脂蛋白与周围神经传导速度的相关性

Correlation of high⁃sensitivity C⁃reactive protein,insulin⁃like growth factor⁃1 and low⁃density lipoprotein with peripheral nerve conduction velocity in patients with type 2 diabetes mellitus

目的:研究2型糖尿病(T2DM)患者超敏C反应蛋白(Hs⁃CRP)、胰岛素样生长因子⁃1(IGF⁃1)及低密度脂蛋白(LDL)与周围神经传导速度的相关性。方法:回顾性选取2018年7月⁃2021年12月南京市高淳人民医院内分泌科收治的456例T2DM患者作为研究对象,根据患者是否合并糖尿病周围神经病变(DPN)分为阳性组(n=208)和阴性组(n=248)。对比两组患者Hs⁃CRP、IGF⁃1、LDL、运动传导速度(NCV)以及临床资料;将单因素分析结果代入logistics回归分析T2DM患者周围神经病变的独立危险因素,并对T2DM患者血清Hs⁃CRP、IGF⁃1、LDL与NCV进行相关性分析。结果:阳性组患者糖尿病病程、BMI、血清Hs⁃CRP和LDL显著高于阴性组,血清IGF⁃1水平以及NCV水平显著低于阴性组(均P<0.05);logistics回归分结果显示:患者Hs⁃CRP≥6.13 mg/L、IGF⁃1≤92.43 ng/L、LDL≥4.05 mmol/L、糖尿病病程≥10年以及BMI≥24.68 kg/m^(2)均是引起T2DM患者发生周围神经病变的独立危险因素(P<0.05);采用Pearson相关性分析发现:血清Hs⁃CRP和LDL水平随着NCV评分的增加而升高,与之呈正相关(P<0.001),血清IGF⁃1水平随着NCV评分的增加而降低,与之呈负相关(P<0.001)。结论:T2DM患者血清Hs⁃CRP、IGF⁃1、LDL是引起T2DM患者发生周围神经病变的独立危险因素,且与患者周围神经传导速度存在明显相关性。

Objective:To investigate the correlation of high⁃sensitivity C⁃reactive protein(Hs⁃CRP),insulin⁃like growth factor⁃1(IGF⁃1)and low⁃density lipoprotein(LDL)with peripheral nerve conduction velocity(NCV)in patients with type 2 diabetes mellitus(T2DM).Methods:A total of 456 T2DM patients admitted to the Department of Endocrinology,Nanjing Gaochun People’s Hospital between July 2018 and December 2021 were retrospectively included in the study.According to the presence of diabetic peripheral neuropathy(DPN),all patients were divided into the positive group(n=208)and negative group(n=248).The levels of Hs⁃CRP,IGF⁃1 and LDL,NCV and clinical data were compared between two groups.The independent risk factors of peripheral neuropathy in T2DM patients were screened by univariate analysis and confirmed by Logistic regression analysis;thereafter,the correlation of serum Hs⁃CRP,IGF⁃1 and LDL with NCV in T2DM patients was analyzed.Results:Compared with the negative group,significantly longer diabetic course,larger body mass index(BMI),higher levels of serum Hs⁃CRP and LDL,but significantly lower levels of serum IGF⁃1 and NCV,were determined in the positive group(all P<0.05).Logistic regression analysis showed that Hs⁃CRP≥6.13 mg/L,IGF⁃1≤92.43 ng/L,LDL≥4.05 mmol/L,diabetic course≥10 years and BMI≥24.68 kg/m^(2) were all independent risk factors for the development of DPN in T2DM patients(all P<0.05).Pearson’s correlation analysis showed that serum Hs⁃CRP and LDL levels increased along with the increasing NCV score,presenting a positive correlation(both P<0.05),and serum IGF⁃1 level decreased along with the increasing NCV score,presenting a negative correlation(P<0.05).Conclusion:Serum Hs⁃CRP,IGF⁃1 and LDL are independent risk factors for DPN in T2DM patients,and are significantly correlated with peripheral NCV.