2型糖尿病患者周围神经病变与血清肿瘤标志物的关系研究

Correlation between peripheral neuropathy and tumor markers in patients with type 2 diabetes mellitus

目的探究2型糖尿病患者周围神经病变(diabetic peripheral neuropathy,DPN)与血清肿瘤标志物之间的关系。方法选取2018年1月至2020年12月在上海交通大学医学院附属新华医院内分泌科住院的40~70岁的2型糖尿病患者956例,其中合并DPN患者347例,无DPN患者609例。分析2组患者之间血清肿瘤标志物水平的差异。分析与DPN独立相关的影响因素,确定影响DPN的肿瘤标志物的切点,并探究该肿瘤标志物的影响因素。结果2型糖尿病合并DPN患者组血清癌胚抗原(CEA)、糖类抗原(CA)125、CA211水平较2型糖尿病无DPN患者高(均P<0.05)。CEA、CA211、年龄、HbA_(1C)、糖尿病病程是DPN的独立危险因素。餐后2 h C肽是DPN的保护因素。2型糖尿病患者合并DPN时血清CEA、CA211的切点值分别为2.915 ng/mL和2.115 ng/mL,CEA、CA211在切点值以上时DPN的风险分别是切点值以下的1.803倍(95%CI 1.160~2.802)和1.741倍(95%CI 1.150~2.635)。结论2型糖尿病合并DPN患者血清CEA、CA211水平较无DPN患者显著升高,血清CEA、CA211是DPN的独立危险因素,并有可能成为筛查糖尿病微血管病变的血清学指标。

Objective To investigate the correlation between diabetic peripheral neuropathy(DPN)and the tumor markers in patients with type 2 diabetes(T2DM).Methods A total of 956 patients with T2DM aged 40 to 70 years were hospitalized in the Department of Endocrinology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2020.There were 347 patients suffered from DPN and 609 patients were not.The differences of serum tumor markers between the two groups were analyzed.We explored the influencing factors independently related to DPN,determined the cutoff points of the tumor markers affecting DPN,and investigated the influencing factors of this tumor marker.Results The levels of serum carcinoembryonic antigen(CEA),carbohydrate antigen(CA)125,and CA211 were significantly higher in T2DM patients with DPN than those without DPN(all P<0.05).CEA,CA211,age,HbA_(1C),and diabetic duration were independent risk factors of DPN.The 2 h postprandial C-peptide was the independent protective factor of the DPN.We found the cutoff points of serum CEA and CA211 when the DPN happened were 2.915 ng/mL and 2.115 ng/mL.When the CEA and CA211 levels were above the cutoff points,the incidence risk of DPN was 1.803(95%CI 1.160-2.802)and 1.741(95%CI 1.150-2.635)times respectively,compared to below cutoff values.Conclusion Serum CEA,CA125,and CA211 levels were significantly higher in T2DM patients with DPN than those without DPN.CEA and CA211 were independent risk factors of DPN and could potentially serve as markers for screening diabetic microvascular complications of diabetes mellitus.