体重指数和血清甘油三酯与痛性糖尿病神经病变相关性的研究

Correlation between body mass index,serum triglyceride and painful diabetic neuropathy

目的探讨T2DM患者BMI和血清TG与痛性糖尿病神经病变(PDN)的相关性。方法选取2017年12月至2020年6月于宁夏医科大学总医院内分泌科住院治疗的T2DM患者600例,根据糖尿病周围神经病变(DPN)诊断标准和神经性疼痛问卷分为单纯T2DM组(T2DM,n=155)、DPN组(n=234)和PDN组(n=211)。比较各组BMI、TG等。结果T2DM、DPN、PDN组BMI、TG依次升高(P<0.05)。Spearman相关分析显示,BMI与24 hUAlb呈正相关(P<0.05),TG与TC、24 hUAlb呈正相关(P<0.05)。Logistic回归分析显示,BMI、TG、DM病程、24 hUAlb是PDN的影响因素。受试者工作特征(ROC)曲线分析显示,BMI、TG诊断PDN的敏感度为69.2%、68.7%,特异度为85.9%、86.3%,ROC曲线下面积(AUC)为0.825、0.826(P<0.01)。BMI、TG联合检测的AUC为0.908(P<0.01)。结论BMI和血清TG升高是PDN的影响因素,体育锻炼及降脂药物使用可能为治疗PDN提供新思路。

Objective To investigate the correlation between body mass index(BMI)and serum triglyceride(TG)levels and painful diabetic neuropathy(PDN)in type 2 diabetes mellitus(T2DM)patients.Methods A total of 600 T2DM patients hospitalized in the Endocrinology Department of the General Hospital of Ningxia Medical University were selected in this study from December 2017 to June2020.According to the diagnostic criteria of diabetic peripheral neurophathy(DPN)and the neuropathic pain questionnaire,they were divided into simple T2DM group(T2DM,n=155),DPN group(n=234)and PDN group(n=211).BMI and serum TG were compared among the groups.Results BMI and TG increased in turn in T2DM,DPN and PDN groups.Spearman correlation analysis showed that BMI was positively correlated with 24 hUAlb(P<0.05),and TG was positively correlated with TC and 24 h UAlb(P<0.05).Logistic regression analysis showed that BMI,TG,DM duration and 24 hUAlb were the influencing factors for PDN.The analysis of ROC curve showed that the sensitivity of BMI and TG in diagnosing PDN was 69.2%and 68.7%,the specificity was 85.9%and 86.3%,and the area under the ROC curve(AUC)was 0.825 and 0.826(P<0.01).The AUC of combined BMI and TG test is 0.908(P<0.01).Conclusion The increase of BMI and serum TG are the influencing factors for PDN.Physical exercise and the use of lipid-lowering drugs may provide new ideas for the treatment of PDN.