初诊2型糖尿病患者血小板分布宽度对糖尿病周围神经病变的影响

Effect of platelet distribution width on diabetic peripheral neuropathy in patients with newly diagnosed type 2 diabetes mellitus

目的探讨初诊2型糖尿病(T2DM)患者血小板分布宽度(PDW)对糖尿病周围神经病变(DPN)发生风险的影响。方法回顾性分析2017年1月至2021年12月于徐州医科大学附属徐州市立医院内分泌科住院的1001例初诊T2DM患者的临床资料,采集患者一般资料、血小板相关指标和生化指标,根据有无DPN将患者分为DPN组(n=481)和非DPN组(n=520)。采用易侕软件和R3.4.3进行数据分析。根据数据类型,分别采用t检验、Mann-Whitney U检验或χ^(2)检验进行组间比较。对PDW与生化指标进行Pearson相关性分析。采用logistic回归分析PDW是否为DPN风险的独立影响因素。采用多元线性回归分析PDW是否为神经传导速度的独立影响因素。结果DPN组PDW水平较非DPN组显著增高[(14.58±2.26)和(14.20±2.41)fl,P=0.01]。校正一般资料、血小板相关指标、生化指标的多因素logistic回归分析结果显示,PDW水平是DPN独立危险因素,PDW每增加1个单位DPN风险增加11%(OR=1.11;P<0.05),PDW每增加1个标准差DPN风险增加29%(OR=1.29;P<0.05)。与第一分位相比,PDW在第三分位(OR=2.43;P=0.01)和第四分位(OR=2.01;P<0.05)时DPN风险显著增加。将DPN作为定量指标进行多因素线性回归分析,结果显示PDW水平是神经传导速度独立危险因素。结论初诊T2DM患者中,有DPN者PDW水平较非DPN者显著升高,PDW水平增高是DPN风险的独立危险因素。

Objective To explore the effect of platelet distribution width(PDW)on the risk of diabetic peripheral neuropathy(DPN)in patients with newly diagnosed type 2 diabetes mellitus(T2DM).Methods A retrospective study was conducted on 1001 newly diagnosed T2DM patients admitted to the Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2017 to December 2021.General data,platelet-related indexes and biochemical indexes were collected.They were divided into DPN group(n=481)and non-DPN group(n=520).EmpowerStats and R3.4.3 for Windows were used for statistical analysis.Student′s t test,Mann-Whitney U test or Chi-square test was used for data comparison between two groups.Pearson correlation analysis was performed to evaluate the correlation between PDW and biochemical indexes,logistic regression analysis to analyze whether PDW was an independent factor for DPN risk,and multiple linear regression analysis to determine whether PDW was an independent factor of nerve conduction velocity.Results The PDW value was significantly higher in the DPN group than the non-DPN group[(14.58±2.26)vs(14.20±2.41)fl;P=0.01].After adjusted for general data,platelet-related indexes and biochemical indexes,multivariate regression analysis showed that PDW was an independent risk factor for DPN,with the risk of DPN increasing by 11%per unit increment of PDW value(OR=1.11;P<0.05)and by 29%per standard deviation increment of the value(OR=1.29;P<0.05).Compared with the first quartile,PDW indicated a significantly increased risk of DPN at the third(OR=2.43;P=0.01)and fourth(OR=2.01;P<0.05)quartiles.Multiple linear regression analysis using DPN as a quantitative indicator suggested that PDW was an independent risk factor for nerve conduction velocity.Conclusion In newly diagnosed T2DM patients,PDW value is significantly higher in those complicated with DPN than those without,and it is an independent risk factor for DPN.