男性2型糖尿病患者周围神经病变影响因素分析

Influencing Factors of Peripheral Neuropathy in Male Patients with Type 2 Diabetes

目的:探讨男性2型糖尿病(T2DM)患者并发周围神经病变(DPN)的影响因素。方法:选取2022-01-2023-03在武汉科技大学附属孝感医院内分泌科住院的145例男性T2DM患者。根据患者是否存在临床症状(感觉异常、有疼痛或麻木等)及体征(踝反射、针刺痛觉、震动觉、压力觉、温度觉)将其分为DPN组(n=75)和非DPN组(n=70)。采集两组患者一般资料,检测实验室有关指标,包括:血常规、肝肾功能、电解质血钾(K^(+))、血钙(Ca^(2+))、血清尿酸(UA)、血脂总胆固醇(CHOL)、超敏C反应蛋白(hs-CRP)、糖化血红蛋白(HbA1c):测量踝肱指数(ABI),完善体成分检查;计算中性粒细胞/淋巴细胞(NLR)、下肢肌肉质量/全身肌肉质量(L/W)、小腿围/腰围、身体质量指数(BMI)、稳态模型胰岛贝塔细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR),分析男性T2DM合并DPN的影响因素。结果:DPN组年龄、糖尿病病程、HbA1c、中性粒细胞数(N)、NLR、hs-CRP、VFA高于非DPN组,差异有统计学意义(P<0.05);小腿围、下肢肌肉质量(LEMM)低于非DPN组,差异有统计学意义(P<0.05)。两组患者腰围、小腿围/腰围、身高、体重、BMI、空腹血糖(FBG)、胰岛素(INS)、HOMA-β、HOMA-IR、HGB、UA、CHOL、淋巴细胞数(L)、K^(+)、Ca^(2+)、ABI、L/W、骨骼肌含量、体脂百分比、全身肌肉质量(WBMM)差异无统计学意义(P>0.05)。结论:糖尿病病程、VFA、HbA1c、NLR、hs-CRP是男性T2DM患者DPN的危险性因素,LEMM是保护性因素。

Objective:To investigate the influencing factors of peripheral neuropathy(DPN)in male patients with type 2 diabetes mellitus(T2DM).Method:145 male T2DM patients from January 2022 to March 2023 were selected.Patients were divided into DPN group(n=75)and non-DPN group(n=70)according to the presence of clinical symptoms(paraesthesia,pain or numbness,etc.)and physical signs(ankle reflex,acupuncture pain,vibration,pressure,and temperature).General data of the two groups of patients were collected,and blood routine,liver and kidney function,electrolyte,serum uric acid,blood lipid,hypersensitive C-reactive protein(hs-CRP),and glycated hemoglobin(HbA1c)were detected.Ankle-brachial index(ABI),neutrophil/lymphocyte(NLR),lower limb muscle mass/total body muscle mass(L/W),calf circumference/waist circumference,body mass index(BMI),homeostasis model islet beta cell function index(HOMA-β)and insulin resistance index(HOMA-IR)were analyzed.Results:The age,diabetes course,HbA1c,neutrophil,NLR,hs-CRP and VFA in DPN group were higher than those in non-DPN group,and the differences were statistically significant(P<0.05).Lower extremity muscle mass(LEMM)and lower extremity muscle mass were significantly lower than those in non-DPN group(P<0.05).There was no statistically significant difference in waist circumference,calf circumference/waist circumference,height,weight,BMI,FBG,INS,HOMA-β,HOMA-IR,HGB,UA,CHOL,lymphocyte,K^(+),Ca^(2+),ABI,L/W,skeletal muscle content,body fat percentage(BFP)and whole body muscle mass(WBMM)between the two groups of patients(P>0.05).Conclusion:Duration of diabetes,VFA,HbA1c,NLR and hs-CRP are risk factors for DPN in male T2DM patients,while LEMM is protective factor.