25-羟维生素D水平与糖尿病周围神经病变发生的相关性研究

Correlation study between 25-hydroxyvitamin D level and diabetic peripheral neuropathy

目的探究25-羟维生素D[25-(OH)D]水平预测糖尿病周围神经病变发生的相关性。方法选取2021年6月—2021年12月间在上海市静安区南京西路社区卫生服务中心就诊的200例2型糖尿病患者为研究对象,根据体格检查、血液生化、神经症状评分、肌电图等方法分为无周围神经病变组(n=153)和周围神经病变组(n=47),对比两组患者的一般资料及血清基线25-(OH)D水平,分析25-(OH)D与糖尿病周围神经病变的相关性,采用Logistic回归分析25-(OH)D对糖尿病周围神经病变的预测价值。结果两组患者基线25-(OH)D水平、空腹血糖、糖化血红蛋白(HbA_(1c))、收缩压对比差异有统计学意义(P<0.001),而年龄、性别、BMI、腰围、餐后血糖值、谷草转氨酶、空腹C肽、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)、血肌酐、血尿酸、舒张压对比无明显差异(P>0.05);基线25-(OH)D水平与密歇根糖尿病周围神经病变评分(MDNS)呈负相关(r=-0.583,P<0.001),空腹血糖与MDNS评分呈正相关(r=0.303,P<0.001);Logistic回归分析提示,25-(OH)D每增加一个单位,糖尿病周围神经病变风险下降25%,校正性别、年龄、HbA_(1c)、LDL后,相关性依然存在。结论25-(OH)D水平与糖尿病周围神经病变呈负相关,与该病的发生及发展密切相关,血清25-(OH)D水平可作为预测尿病周围神经病变发生、发展的重要指标。

Objective To explore the correlation of 25-hydroxyvitamin D[25-(OH)D]level in predicting the occurrence of diabetic peripheral neuropathy.Methods A total of 200 patients with type 2 diabetes mellitus(T2DM)who were admitted to Community Health Service Center of West Nanjing Road,Jing’an District,Shanghai from June 2021 and December 2021 were selected as the study subjects.According to physical examination,blood biochemistry,neurological symptom score and electromyography,the patients were divided into two groups:no peripheral neuropathy group(n=153)and peripheral neuropathy group(n=47).The general data and serum baseline 25-(OH)D levels of the two groups were compared to analyze the correlation between 25-(OH)D and diabetic peripheral neuropathy.The predictive value of 25-(OH)D in diabetic peripheral neuropathy was analyzed by Logistic regression.Results There were significant differences in baseline 25-(OH)D level,fasting blood glucose(FBG),HbA_(1c) and SBP between two groups(P<0.001),but no significant differences in age,sex,BMI,waist circumference,postprandial plasma glucose,AST,C-peptid total cholesterol,HDL-C,triglyceride,LDL-C,Scr,UA and DBP between two groups(P>0.05).Baseline 25-(OH)D level was negatively correlated with MDNS score(r=-0.583,P<0.001),and FBG was positively correlated with MDNS score(r=0.303,P<0.001).Logistic regression analysis showed that the DPN risk decreased by 25%for every unit increase of 25-(OH)D,and the correlation remained after timely adjustment for sex,age,HbA_(1c),and LDL-C.Conclusions The level of 25-(OH)D is negatively correlated with the occurrence and development of diabetic peripheral neuropathy,and the detection of serum 25-(OH)D level can be used as an important indicator to predict the occurrence and development of urinary peripheral neuropathy.