初诊2型糖尿病患者内脏脂肪面积与周围神经病的相关性分析

Correlation Analysis between Visceral Fat Area and Peripheral Neuropathy in Patients with Newly Diagnosed Type 2 Diabetes Mellitus

目的:探究初诊2型糖尿病(diabetes mellitus type 2,T2DM)患者内脏脂肪面积(vsceral fat area,VFA)与糖尿病周围神经病(diabetic peripheral neuropathy,DPN)的相关性。方法:纳入十堰市太和医院初诊T2DM患者250例,分为DPN组(n=129)和非DPN组(n=121),收集两组患者的一般资料、血常规、血脂、肾功能、内脏脂肪面积、皮下脂肪面积等指标。分析初发T2DM患者内脏脂肪面积与周围神经病的相关性。结果:Spearman相关性分析发现内脏脂肪面积与2型糖尿病周围神经病变呈显著正相关(rs=0.542,P<0.001)。根据BMI将患者分为正常组(BMI<24 kg/m^(2))和超重组(BMI≥24 kg/m^(2)),分别对体质量分组及内脏脂肪分组进行多因素Logistic回归分析,在校正年龄、皮下脂肪面积、BMI、单核细胞、LDL-c、FBG、HOMA-IR、糖化血红蛋白后,正常组内脏脂肪增厚,发生DPN的风险增加(OR=1.045,95%CI:1.006,1.085,P=0.023);超重组内脏脂肪增厚,发生DPN的风险增加(OR=1.031,95%CI:1.012,1.050,P=0.001);而在不同内脏脂肪分组中,BMI与DPN的关系无统计学意义(P>0.05)。结论:不论体质量是否超标,初诊T2DM内脏脂肪肥胖与合并周围神经病变密切相关,因此,对于初诊T2DM患者内脏评估有利于早期发现2型糖尿病周围神经病。

Objective To explore the correlation between visceral fat area(VFA)and diabetic peripheral neuropathy(DPN)in newly diagnosed type 2 diabetes mellitus(T2DM).Methods 250 patients with newly diagnosed T2DM were enrolled in Taihe Hospital of Shiyan City,including 129 patients with DPN(DPN group)and 121 patients without DPN(non-DPN group).The general data,blood routine,blood lipid,renal function,VFA and subcutaneous fat area of the two groups were collected.To analyze the correlation between VFA and peripheral neuropathy in patients with T2DM.Results Spearman correlation analysis showed that VFAwas positively correlated with type 2 diabetic peripheral neuropathy(rs=0.542,P<0.001).Patients were divided into normal weight group(BMI<24 kg/m^(2))and overweight group(BMI≥24 kg/m^(2))according to BMI.Multivariate logistic regression analysis was performed on weight group and visceral fat group.After adjusting for age,subcutaneous fat area,BMI,monocyte,LDL-c,FBG,HOMA-IR and glycosylated hemoglobin,the visceral fat was thickened and the risk of DPN increased in normal weight group(OR=1.045,95%CI:1.006,1.085,P=0.023).Overweight visceral fat thickened and the risk of DPN increased(OR=1.031,95%CI:1.012,1.050,P=0.001),but there was no significant relationship between BMI and peripheral neuropathy in different visceral fat groups(P>0.05).Conclusion visceral fat obesity in newly diagnosed T2DM is closely related to peripheral neuropathy,regardless of whether the body weight is overweight or not.Therefore,visceral assessment in newly diagnosed T2DM patients is conducive to the early detection of type 2 diabetic peripheral neuropathy.