皮肤自发荧光糖基化产物与老年2型糖尿病周围神经病变的相关性研究

The association between autofluorescence of skin advanced glycation end products and diabetic peripheral neuropathy in elderly patients with type 2 diabetes mellitus

目的探讨老年2型糖尿病病人皮肤自发荧光(SAF)与周围神经病变(DPN)之间的关系。方法纳入2022年8—9月于太原市尖草坪区汇丰社区卫生服务中心体检的52例老年2型糖尿病病人,收集病人资料,行DPN检查和SAF测定。根据DPN检查结果分为DPN组(n=21)和非DPN组(n=31),比较两组病人SAF水平并探索SAF对DPN的筛查价值。结果(1)与非DPN组[(2.27±0.32)AU]相比,DPN组[(2.70±0.94)AU]的SAF值显著升高(P<0.05)。根据SAF测量值分为低、中、高SAF组,结果显示饮酒和血肌酐升高与SAF升高有关(P<0.05)。(2)调整混杂因素空腹血糖和HbA1c后,二元logistic回归分析显示,高SAF病人发生DPN的风险是低SAF的6.98倍[OR=6.98,95%CI:(1.47,33.17),P=0.014]。(3)以DPN为因变量进行受试者操作特征曲线(ROC曲线)分析,SAF、空腹血糖联合HbA1c筛查DPN的曲线下面积为0.77,灵敏度为66.7%,特异度为77.4%。结论SAF是老年2型糖尿病病人发生DPN的独立危险因素,作为一种新型无创标志物,可联合空腹血糖和HbA1c发挥筛查DPN的作用。

Objective This study aimed to investigate the association between skin autofluorescence(SAF)and diabetic peripheral neuropathy(DPN)in elderly patients with type 2 diabetes mellitus.Methods Fifty-two elderly patients with type 2 diabetes mellitus tested in Huifeng community health service center in Jiancaoping district in Taiyuan were included in the study.Basic information was collected,and DPN examination and SAF measurement were performed.The patients were divided into a DPN group(n=21)and a nonDPN group(n=31)based on the results of DPN examination to compare SAF levels and explore the screening value of SAF for DPN.Re⁃sults(1)SAF values were significantly higher in the DPN group[(2.70±0.94)AU]than the non-DPN group[(2.27±0.32)AU],with a statistically significant difference(P<0.05).The participants were further divided into low,moderate,and high SAF groups,which revealed that alcohol consumption and hypertriglyceridemia were associated with elevated SAF with statistically significant differences(P<0.05).(2)After adjusting for confounding factors such as fasting glucose and HbA1c,binary logistic regression analysis showed that SAF was an independent risk factor for DPN[OR=6.98,95%CI:(1.47,33.17),P=0.014].(3)The ROC curves were plotted with DPN as the dependent variable,and the area under the curves for SAF combined with fasting glucose and HbA1c screening for DPN was 0.77,with a sensitivity of 66.7%and a specificity of 77.4%.Conclusion SAF,a novel non-invasive marker,is an independent risk factor for DPN in elderly patients with type 2 diabetes mellitus and can be used in combination with fasting glucose and HbA1c screenings for DPN.