2型糖尿病合并周围神经病变病人血清Cys-C水平与神经传导参数的相关性

Correlation between Serum Cys-C and Nerve Conduction Parameters in Patients with T2DM Complicated with Diabetic Peripheral Neuropathy

目的:分析血清胱抑素C(Cys-C)表达水平与2型糖尿病(T2DM)合并周围神经病变(DPN)病人神经传导参数的相关性。方法:选取2021年1月—2021年11月广汉市人民医院收治的118例T2DM病人,根据DPN并发情况将其分为合并DNP组(61例)和单纯T2DM组(57例)。比较两组一般资料、血清Cys-C水平及神经传导参数,分析血清Cys-C与神经传导参数的相关性,评估Cys-C与神经传导参数对T2DM病人DPN并发情况的预测效能。结果:两组性别、年龄、体质指数(BMI)、舒张压比较差异均无统计学意义(P>0.05),合并DNP组糖尿病病程明显长于单纯T2DM组(P<0.05),收缩压明显大于单纯T2DM组(P<0.05);合并DNP组血清Cys-C水平均明显高于单纯T2DM组(P<0.05),正中神经感觉传导速度(SCV)、正中神经运动传导速度(MCV)、腓总神经SCV、腓总神经MCV均明显低于单纯T2DM组(P<0.05)。Pearson相关性分析表明,T2DM合并DNP病人血清Cys-C水平与正中神经SCV、正中神经MCV、腓总神经SCV、腓总神经MCV均呈负相关(P<0.05);受试者工作特征(ROC)曲线分析显示,血清Cys-C、正中神经SCV、正中神经MCV、腓总神经SCV、腓总神经MCV预测T2DM病人并发DPN的AUC分别为0.749,0.819,0.872,0.821,0.836,联合诊断AUC可达到0.977,联合诊断价值更高。结论:T2DM合并DPN病人血清Cys-C水平呈明显上升,且存在上下肢感觉、运动神经传导受损情况,血清Cys-C及神经传导参数可作为T2DM病人并发DPN的参考指标。

Objective:To analyze the correlation between expression level of serum cystatin C(Cys-C)and nerve conduction parameters in patients with type 2 diabetes mellitus(T2DM)complicated with diabetic peripheral neuropathy(DPN).Methods:One hundred and eighteen patients with T2DM were divided into combined DNP group(n=61)and pure T2DM group(n=57)according to whether DPN occurred or not.The baseline data,serum Cys-C level,and nerve conduction parameters were compared between two groups.The correlation between serum Cys-C and nerve conduction parameters was analyzed.The predictive efficiency of Cys-C and nerve conduction parameters in DPN in patients with T2DM was evaluated.Results:There were no significant differences in baseline data such as gender,age,body mass index(BMI),and diastolic blood pressure between two groups(P>0.05),and the course of diabetes mellitus in combined DNP group was significantly longer than that in pure T2DM group(P<0.05),and the systolic blood pressure was significantly higher than that in pure T2DM group(P<0.05).Serum Cys-C level was significantly higher in combined DNP group than that in pure T2DM group(P<0.05),and the median nerve sensory conduction velocity(SCV),median nerve motor conduction velocity(MCV),common peroneal nerve SCV,common peroneal nerve MCV were significantly slower than those in pure T2DM group(P<0.05).Pearson correlation analysis indicated that serum Cys-C level in patients with T2DM complicated with DNP was significantly negatively correlated with median nerve SCV,median nerve MCV,common peroneal nerve SCV,and common peroneal nerve MCV(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that area under the curve(AUC)values of the above indicators alone and in combination in predicting the occurrence of DPN in patients with T2DM were 0.749,0.819,0.872,0.821,0.836,and 0.977(all P<0.05),and the combined diagnosis had higher value.Conclusion:Serum Cys-C level in patients with T2DM complicated with DPN is significantly up-regulated and the sensory and motor nerve conduction of the upper and lower limbs are impaired.Serum Cys-C and nerve conduction parameters can be used as reference indicators for patients with T2DM complicated with DPN.