糖尿病肾病合并糖尿病周围神经病变患者血清C肽水平及其与肾功能、神经传导速度的相关性

Level of serum C-peptide and its correlation with renal function and nerve conduction velocity in patients with diabetic nephropathy and concomitant diabetic peripheral neuropathy

目的探讨糖尿病肾病(DN)合并糖尿病周围神经病变(DPN)患者血清C肽水平及其与肾功能、神经传导速度的相关性。方法选取121例DN患者,根据其是否合并DPN将其分为合并DPN组56例和单纯DN组65例,另选取同期40例健康体检者作为健康组。比较3组研究对象的空腹C肽(FCP)水平、餐后2 h C肽(2hPCP)水平、肾功能指标[血清尿素氮、血清肌酐、24 h尿蛋白]水平、右腓总神经运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)。分析合并DPN组患者血清C肽水平与肾功能指标水平、神经传导速度的关系。结果合并DPN组的FCP、2hPCP水平均低于单纯DN组与健康组,单纯DN组的2hPCP水平低于健康组(均P<0.05),而健康组与单纯DN组的FCP水平差异无统计学意义(P>0.05)。合并DPN组的24 h尿蛋白、血清尿素氮、血清肌酐水平均高于单纯DN组与健康组,单纯DN组的上述指标均高于健康组(均P<0.05)。合并DPN组的MNCV、SNCV均慢于单纯DN组与健康组(均P<0.05),而健康组与单纯DN组的MNCV、SNCV差异均无统计学意义(均P>0.05)。合并DPN组患者的FCP、2hPCP水平与24 h尿蛋白、血清尿素氮、血清肌酐水平均呈负相关,与MNCV、SNCV均呈正相关(均P<0.05)。结论相比于单纯DN患者,合并DPN的DN患者的血清C肽水平降低、肾功能障碍程度更明显,且存在周围神经传导功能障碍。DN合并DPN患者的血清C肽水平与肾功能及周围神经传导障碍程度相关。

Objective To investigate the level of serum C-peptide and its correlation with renal function and nerve conduction velocity in patients with diabetic nephropathy(DN)and concomitant diabetic peripheral neuropathy(DPN).Methods A total of 121 DN patients were selected,and they were divided into concomitant DPN group(56 cases)or simple DN group(65 cases)according to the presence of concomitant DPN,and another 40 healthy check-up individuals during the same period were selected as healthy group.The fasting C-peptide(FCP)level,2-hour postprandial C-peptide(2hPCP)level,and renal function indices with respect to serum urea nitrogen,serum creatinine,24-hour urine protein levels,as well as motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of right common peroneal nerve in the research subjects were compared between the three groups.The relation of serum C-peptide level with renal function indices levels and nerve conduction velocity of patients in the concomitant DPN group was analyzed.Results The concomitant DPN group exhibited lower levels of FCP,2hPCP as compared with the simple DN and healthy groups,and the simple DN group interpreted a lower 2hPCP level compared to the healthy group(all P<0.05),whereas there was no statistically significant difference in FCP level between the healthy group and the simple DN group(P>0.05).The concomitant DPN group yielded higher levels of 24-hour urine protein,serum blood urea nitrogen,and serum creatinine as compared with the simple DN and healthy groups,and the simple DN group exhibited higher indices as above as compared with the healthy group(all P<0.05).The concomitant DPN group depicted slower MNCV and SNCV compared to the simple DN group and the healthy group(all P<0.05),whereas no statistically significant difference in MNCV and SNCV was found between the healthy group and the simple DN group(all P>0.05).FCP and 2hPCP levels negatively correlated with 24-hour urine protein,serum blood urea nitrogen and serum creatinine levels of patients in the concomitant DPN group,and positively correlated with MNCV and SNCV of patients in the concomitant DPN group(all P<0.05).Conclusion Compared to patients with simple DN,patients with DN and concomitant DPN obtain obvious degrees of decreased serum C-peptide level and renal dysfunction,and the presence of nerve conduction dysfunction.Serum C-peptide level is associated with degrees of renal function dysfunction and peripheral nerve conduction dysfunction in patients with DN and concomitant DPN.