血清性激素结合球蛋白水平与糖尿病周围神经病变的关系

目的研究血清性激素结合球蛋白(SHBG)水平与糖尿病周围神经病变(DPN)的相关性。方法 2型糖尿病(T2DM)患者198例,按照是否并发DPN分为单纯T2DM组(T2DM组,n=69)及T2DM合并DPN组(DPN组,n=129)。进一步根据多伦多临床评分系统(TCSS)将DPN组分为轻度DPN组(n=49),中度DPN组(n=43),重度DPN组(n=37)。比较T2DM组及DPN各亚组的临床资料、实验室指标(包括血清SHBG、血生化、血糖相关指标等),进一步采用二元Logistic回归分析对DPN的危险因素进行分析。应用受试者工作特征(ROC)曲线分析以血清SHBG水平对DPN诊断的价值。结果 DPN组年龄、病程、腰围、收缩压、踝肱指数(ABI)、血尿酸(UA)、稳态模型胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)、糖化血红蛋白(HbA 1c)水平显著高于DM组,而血清SHBG显著低于T2DM组,且其水平与DPN病情严重程度呈负相关。Logistic回归分析提示,SHBG水平升高为DPN的保护因素(OR=0.679),而糖尿病病程、FPG、ABI、UA水平、HbA1c为危险因素(OR=1.423,1.054,5.507,2.809,1.896)。ROC曲线分析以血清SHBG水平区分DPN组与T2DM组的曲线下面积为0.802(95%CI:0.725～0.880,P=0.000),截断值取44.02 mmol/L时,敏感性与特异性分别为82.9%与61.5%。结论 SHBG水平下降与DPN的发生存在相关性,其可能是DPN发生发展的危险因素,血清SHBG水平检测对DPN有一定的诊断效能,为DPN的临床诊疗提供新策略。     

中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及同型半胱氨酸与2型糖尿病患者冠心病的关系研究

背景 2型糖尿病(T2DM)并冠心病患者因早期无明显临床表现而常漏诊,因此寻找直观、简便且稳定性较好的临床指标对早期预测T2DM患者冠心病发生风险具有重要意义。目的分析中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及同型半胱氨酸(Hcy)与T2DM患者冠心病的关系。方法选取2018年1—10月盘锦辽油宝石花医院收治的T2DM并冠心病患者73例作为观察组,另选取同期收治的单纯T2DM患者86例作为对照组。比较两组患者一般资料及实验室检查指标,T2DM患者冠心病的影响因素分析采用多因素Logistic回归分析。结果 (1)观察组患者年龄大于对照组,收缩压高于对照组,糖尿病病程长于对照组(P0.05);两组患者性别、体质指数(BMI)、腰臀比、舒张压、高血压病史及高脂血症病史比较,差异无统计学意义(P0.05)。(2)观察组患者NLR、PLR及Hcy高于对照组(P0.05);两组患者空腹血糖(FBG)、三酰甘油(TG)及总胆固醇(TC)比较,差异无统计学意义(P0.05)。(3)多因素Logistic回归分析结果显示,年龄[OR=3.108,95%CI(2.015,4.793)]、收缩压[OR=1.970,95%CI(1.579,2.458)]、糖尿病病程[OR=3.827,95%CI(2.326,6.296)]、NLR[OR=3.466,95%CI(2.204,5.451)]、PLR[OR=3.340,95%CI(2.724,4.095)]及Hcy[OR=7.164,95%CI(2.372,21.638)]是T2DM患者冠心病的独立影响因素(P0.05)。结论 NLR、PLR及Hcy是T2DM患者冠心病的独立影响因素,定期监测NLR、PLR及Hcy水平有利于预防及早期发现T2DM患者冠心病。     

2型糖尿病周围神经病变患者嗅觉、味觉功能评估及意义的研究

目的探讨T2DM周围神经病变患者嗅觉、味觉功能情况及临床意义。方法选取2015年9月至2017年12月于我院内分泌科住院及门诊接受治疗的90例T2DM患者(T2DM组)、63例糖尿病周围神经病变患者(DPN组)以及体检中心健康体检人群104名(NC组),分析各组嗅觉、味觉功能指标的表达差异。结果 DPN组病程、长期吸烟史、HbA1c、高敏C反应蛋白(hsC-RP)、间接胆红素(IBIL)与T2DM组、NC组比较,差异有统计学意义(P0.05或P0.01)。Pearson相关分析显示,嗅觉评分总分(TDI)、味觉评分总分(DTV)均与病程、长期吸烟史、HbA1c、LDL-C、hsC-RP呈负相关(P0.05或P0.01),与IBIL呈正相关(P0.05)。Logistic回归分析结果显示,病程(OR=2.232,95%CI1.443～6.223)、长期吸烟史(OR=1.826,95%CI 1.076～5.444)、HbA1c(OR=2.117,95%CI 1.572～8.336)、LDL-C(OR=1.909,95%CI 1.201～6.224)、IBIL(OR=1.776,95%CI 1.063～5.023)及hsC-RP(OR=2.446,95%CI1.338～7.061)是DPN的危险因素。结论 T2DM并发DPN患者存在嗅觉、味觉功能障碍,可能与血糖控制、炎症反应等有关。     

住院2型糖尿病患者肌少症相关因素影响分析

目的探讨住院T2DM患者肌少症发生率及其相关影响因素。方法选取2018年7月至2019年3月于南京中医药大学附属昆山市中医医院内分泌科住院的T2DM患者279例,收集患者性别、年龄、BMI、病程、HbA1c、TG、LDL-C、骨代谢指标及糖尿病周围神经病变(DPN)资料。双能X线吸收法测定患者身体成分,按照亚洲肌少症工作组诊断标准将研究对象分为合并肌少症组(Sar,n=132)和非合并肌少症组(T2DM,n=147),比较两组各项指标。结果 T2DM患者肌少症总发生率为47.31%,男性高于女性(53.61%vs 38.05%,P0.05)。T2DM患者DPN发生率为21.15%,Sar组高于T2DM组(31.82%vs 11.56%,P0.05)。Sar组年龄、DM病程高于T2DM组[(61.77±11.42)vs(54.05±12.90)岁,(8.85±7.22)vs(6.40±6.03)年,P0.05],TG、BMI低于T2DM组[(1.4±0.90)vs(2.03±2.27)mmol/L,(22.99±2.87)vs(26.93±3.31)kg/m2,P0.05]。多因素Logistic回归分析显示,年龄[OR 1.076,95%CI(1.045,1.109),P0.01]、性别[OR 4.576,95%CI(2.288,9.153),P0.01]、DPN[OR 2.844,95%CI(1.243,6.511),P0.05]是T2DM患者发生肌少症的危险因素,BMI[OR 0.605,95%CI(0.529,0.692),P0.01]是T2DM患者发生肌少症的保护因素。结论 DPN是T2DM患者发生肌少症的危险因素,尽早筛查及治疗DPN可能减少或延缓肌少症发生。     

南京市社区2型糖尿病患者代谢指标达标和微血管并发症患病现况及影响因素分析

目的调查南京市社区T2DM患者血糖、血压、血脂达标及微血管并发症患病现况并分析其影响因素。方法选取2016年11月至2017年6月南京市10家社区卫生服务中心1956例T2DM患者,评估血糖、血压、血脂达标及DKD、糖尿病周围神经病变(DPN)现况。结果纳入患者的血糖、血压、血脂达标率分别为42.2%、31.4%、39.4%,三者均达标的为5.7%,合并DKD、DPN的为44.1%、50.4%。糖尿病病程≥5年、BMI≥24 kg/m^2和腹型肥胖患者血糖达标率低。多因素Logistic回归分析显示,腹型肥胖(OR 1.340,95%CI 1.050~1.710,P=0.018)、糖尿病病程5~10年(OR1.970,95%CI 1.540~2.510,P<0.01)、糖尿病病程≥10年(OR 3.110,95%CI 2.430~3.990,P<0.01)是血糖不达标的危险因素;女性、年龄≥65岁、BMI≥28 kg/m^2、糖尿病病程≥10年、血压、血糖不达标是DKD的危险因素;年龄≥65岁是DPN的危险因素。结论南京市社区T2DM患者血糖、血压、血脂综合控制达标率有待提高,糖尿病微血管并发症需加强管理。     

2型糖尿病患者并发糖尿病足的相关危险因素分析

目的探讨2型糖尿病(T2DM)患者合并糖尿病足(DF)的相关危险因素。方法选取2型糖尿病(T2DM)患者共219例,按是否合并DF分为DF组(n=32例)和非DF组(n=187例),记录和比较两组患者一般资料及实验室检查结果,并采用多因素Logistic回归分析分析DF相关危险因素。结果 DF组与非DF组患者在年龄、T2DM病程、BMI、SBP、DBP、DR、DPN、DN、2h PG、Hb A1C、Scr、BUN等方面比较差异均有统计学意义(P0.05),而性别、吸烟史、FPG、TG、TC、LDL-C、HDL-C等方面比较差异均无统计学意义(P0.05);进一步的多因素Logistic回归分析结果显示T2DM病程、Hb A1C、DPN、DN是T2DM患者合并DF的独立危险因素。结论 T2DM患者的T2DM病程、Hb A1C、DPN、DN为DF的独立危险因素。     

中性粒细胞/淋巴细胞比值与新诊断早期糖尿病肾病的相关性研究

目的探讨中性粒细胞/淋巴细胞比值(NLR)的变化与新诊断早期糖尿病肾病(EDN)的关系。方法 新诊断T2DM患者160例根据有无EDN分为EDN组和单纯T2DM组。检测两组一般资料和生化指标。结果 EDN组NLR、中性粒细胞计数、2 hPG、HbA_1c和年龄高于T2DM组[NLR(2.27±0.92)vs(1.81±0.56);中性粒细胞计数(4.35±1.47)vs(3.78±1.08)10~9/L;2 hPG(21.98±4.30)vs(20.37±4.40)mmol/L;HbA_1c(11.06±2.02)%讲(10.22±1.89)%;年龄(49.22±12.71)vs(44.41±10.81)岁](P0.05)。Logistic回归分析显示,NLR(OR=6.529,95%CI:1.946~21.873,P=0.002)和2 hPG(OR=1.213,95%CI:1.002~1.467,P=0.047)是EDN的独立危险因素。结论 NLR升高与EDN相关,NLR值升高可能是EDN良好的预测指标。     

中性粒细胞与淋巴细胞比值与2型糖尿病患者并发冠心病的相关性

目的:探讨中性粒细胞与淋巴细胞比值(NLR)与2型糖尿病(T2DM)患者并发冠心病的相关性。方法:收集T2DM患者330例,根据冠状动脉造影结果将研究对象分为冠心病组114例和对照组216例,采集各组外周静脉血进行中性粒细胞和淋巴细胞计数,计算NLR。Logistic回归分析T2DM并发冠心病的危险因素。结果:冠心病组与对照组间空腹血糖、高密度脂蛋白、肌酐、尿酸、NLR比值及吸烟率比较,差异有统计学意义(P0.05);NLR2.85组冠心病患者Gensini评分明显高于NLR≤1.99组和1.99NLR≤2.85组冠心病患者的Gensini评分(P均0.001);Logistic回归分析结果显示,NLR、LDL-C是T2DM患者并发冠心病的危险因素(OR值分别为3.282和1.603,P0.05)。结论:NLR可能是T2DM患者并发冠心病的一个较好的相关性指标。     

甲状腺功能正常的2型糖尿病患者血清甲状腺激素水平与糖尿病周围神经病变的相关性研究

目的探讨甲状腺功能正常的T2DM患者血清甲状腺激素(TH)水平与糖尿病周围神经病变(DPN)的相关性。方法选取2018年6月至2019年12月于南昌大学第三附属医院内分泌科住院治疗的T2DM患者1114例,分为合并DPN组(DPN,n=415)和单纯T2DM组(T2DM,n=699),比较两组各项指标,Logistic回归分析DPN的影响因素,分析不同血清游离三碘甲状腺原氨酸(FT_3)水平与DPN风险的相关性。受试者工作特征曲线(ROC)分析FT_3对DPN的诊断价值。结果 DPN组男性比例、DM病程、吸烟史、WHR、FPG、2 h PG、Hb A_1c、血肌酐(Scr)均高于T2DM组(P0.05),FC-P、2 h C-P、谷丙转氨酶、谷草转氨酶、FT_3、FT_3/血清游离甲状腺素比值低于T2DM组(P0.05)。Logistic回归分析显示,校正性别、DM病程、Hb A_1c、2 h C-P后,FT_3是T2DM患者DPN的影响因素(P0.01)。根据FT_3水平将患者进行四分位分组(Q1、Q2、Q3、Q4),Q2、Q3、Q4组DPN患病率低于Q1组(P0.05或P0.01)。ROC曲线下面积为0.568。结论 FT_3是T2DM患者DPN的影响因素,但不能作为预测DPN患病风险的因素。     

糖尿病周围神经病变患者的电生理检查结果及患病危险因素分析

目的观察糖尿病周围神经病变(DPN)的电生理检查结果 ,分析患病危险因素。方法 354例T2DM患者均行神经传导速度(NCV)和皮肤交感反应(SSR)检测,根据结果分为合并DPN(DPN)组228例与未合并DPN(NDPN)组126例。比较两组一般资料、生化指标及糖尿病并发症发生率。采用Logistic回归分析DPN的危险因素。结果 NCV联合SSR检出DPN的异常率较单独应用NCV或SSR高(64.4%vs56.2%vs 32.8%,χ~2=76.401,P=0.000);DPN组年龄、糖尿病病程、2 hPG、DR和糖尿病慢性肾脏疾病(CKD)患病率均高于NDPN组(P0.05);年龄、糖尿病病程、合并DR是T2DM合并DPN的独立危险因素(P0.05)。结论 NCV与SSR联合应用可提高DPN的检出率;高龄、糖尿病病程长、合并DR均可导致T2DM并发DPN的风险增加。     

血管内皮生长因子基因3'-非翻译区936C/T多态性与2型糖尿病外周神经病变相关

目的 探讨血管内皮生长因子(VEGF)基因3'-非翻译区936C/T多态性与山东地区汉族人2型糖尿病合并周围神经病变(DPN)之间的关系.方法 194例糖尿病患者分为单纯糖尿病组(n=92)和糖尿病神经病变组(n=102),另120名健康个体设为健康对照组.采用PCR-限制性片段长度多态性(RFLP)方法确定全部个体的基因型;对不同基因型间及病例组间的临床与生化参数、血清VEGF浓度以及VEGF基因936C/T多态性进行了统计分析.结果 糖尿病神经病变组C等位基因及CC基因型频率显著高于对照组(x2为9.406和9.677,P＜0.05)和糖尿病组(x2为5.578和5.614,P＜0.05),而携带T等位基因的基因型(CT+TT)频率及T等位基因频率显著低于对照组(x2为9.406和9.677,P＜0.05)和糖尿病组(x2为5.578和5.614,P＜0.05).Logistic多元回归分析显示血清低密度脂蛋白胆固醇(LDL-C)、总胆固醇、HbA1c水平以及VEGF浓度与DPN发生呈正相关,而VEGF基因936C/T多态性与糖尿病周围神经病变发病危险呈负相关(β=-1.046,OR=0.457,P=0.006,95%CI:0.166～0.741).结论 中国山东地区汉族人群中存在VEGF基因936C/T多态性,C等位基因及CC基因型患者可能是糖尿病易于发生神经病变危险性的遗传标志,而T等位基因和携带T等位基因的基因型(936TF基因型和936CT基因型)可能是降低糖尿病发生神经病变风险的遗传标志.

Abstract：

Objective To elucidate the relationship between a 936C/T mutation at 3'-untranslated region of human vascular endothelial growth factor(VEGF) gene and diabetic peripheral neuropathy ( DPN ). Methods All subjects recruited in this study were assigned into DM (n = 92, diabetes without neuropathy, retinopathy or nephropathy), DPN (n = 102, diabetes with peripheral neuropathy only ), and healthy control (n = 120 ) groups,respectively. The gene polymorphism was determined by PCR-RFLP, as well as the other clinical parameters including serum VEGF by ELISA. Results The frequencies of both genotype CC and allele C were significantly higher in DPN group than those in either DM group(x2 = 5.578 and 5.614, P＜0. 05 ) or control group (x2 = 9. 406 and 9. 677, P＜0. 05 ). However, the frequencies of genotype(CT+TT) and allele T were significantly lower in DPN group than that in either DM group(x2 =5.578 and 5.614, P＜0. 05) and control group (x2=9.406 and 9.677, P＜0.05). The multivariate logistic regression analysis showed that the levels of HbA1c, total cholesterol, low-density lipoproteincholesterol( LDL-C ), and serum VEGF positively correlated with DPN, while the 936C/T polymorphism of VEGF gene negatively correlated with DPN(β= -1. 046, OR=0. 457, P=0. 006, 95% CI: 0. 166-0. 741 ). Conclusions Allele 936C of VEGF gene may serve as a genetic marker susceptible to DPN, while allele 936T may be a protective genetic marker of DPN.     

慢性低度炎性反应与糖尿病肾脏疾病的相关性分析:一项大样本病例-对照研究

目的 探讨慢性低度炎性反应与糖尿病肾脏疾病(DKD)的关系.方法 将1254例2型糖尿病患者分为DKD组(487例)与单纯T2DM组(767例),DKD诊断依据:符合估算的肾小球滤过率(eGFR)＜ 60 mL/(min·1.73 m2)或尿微量白蛋白/肌酐比值(UACR) ≥30 mg/g.通过自动分析仪测定血清慢性低度炎性反应指标:超敏C反应蛋白(hs-CRP)、白细胞总数、中性粒细胞百分比(NCR),并记录性别、病程、收缩压、舒张压等指标.利用多元Logistic回归分析慢性低度炎性反应指标与DKD的关系.结果 与单纯T2DM组相比,DKD组的hs-CRP、白细胞总数、NCR均显著升高(t=-3.60、-3.43、3.10,P均＜0.01).多元Logistic回归分析显示,hs-CRP(OR=1.116,95％ CI:1.042 ～1.195,P=0.002)、白细胞总数(OR=1.092,95％ CI:1.002 ～1.189,P=0.044)和NCR(OR =1.018,95％ CI:1.004～ 1.033,P=0.015)与DKD风险增加显著相关.结论 DKD的慢性低度炎性反应指标显著升高,hs-CRP、白细胞总数、NCR是DKD的独立危险因素.     

2型糖尿病患者血清脂联素与肝脏脂肪含量的相关性研究

目的 探讨2型糖尿病患者血清脂联素水平与肝脏脂肪含量及相关临床指标的相关性.方法 选取天津市第三中心医院收治的初发2型糖尿病患者108例,以患者肝脏脂肪含量测定结果的平均数为切点将其分为2型糖尿病伴低肝脏脂肪含量组(T2DM+ LFC组)50例和2型糖尿病伴高肝脏脂肪含量组(T2DM+ HFC组)58例.应用高效液相层析法、葡萄糖氧化酶法、放射免疫法以及ELISA等分别对两组患者的相关临床指标及血清脂联素水平进行检测.采用t检验或X2检验进行组间对比,采用Spearman相关分析和多元逐步回归分析进行指标间关系判定,采用Logistic回归分析影响肝脏脂肪含量的危险因素.结果 T2DM+ HFC组血清脂联素水平显著低于T2DM+ LFC组(t=3.947,P=0.006).2型糖尿病患者血清脂联素水平与体重、体重指数、体脂含量、内脏脂肪面积、肝脏脂肪含量、甘油三酯水平呈显著负相关(r=-0.680 ～-0.225,P＜0.05或0.01).多元逐步回归分析显示,体重、体重指数和体脂含量是血清脂联素水平的独立相关因素.Logistic回归分析显示,体重(OR=1.288,95％ CI:1.009 ～ 1.644)、脂联素(OR=0.169,95％ CI:0.053 ～0.542)、γ-谷氨酰胺转肽酶(OR=1.155,95％ CI:1.032～ 1.293)及甘油三酯(OR=0.323,95％ CI:0.172～0.609)为2型糖尿病患者肝脏脂肪含量的影响因素.结论 血清脂联素水平与体重、体重指数和体脂含量密切相关,并可能在2型糖尿病患者肝脏脂质沉积过程中发挥重要调节作用.     

Factors associated with relative muscle strength in patients with type 2 diabetes mellitus

ObjectivesSome patients with type 2 diabetes mellitus (T2DM) experience decreased mobility associated with lower relative muscle strength (normalized with muscle mass). This study aimed to identify factors predicting relative muscle strength of patients with T2DM assessed at regular clinical visits.MethodsA total of 144 T2DM patients underwent fasting blood drawing (determining white blood cell count [WBC], diabetic kidney disease [DKD], and glycated hemoglobin [HbA1c]) and the assessment of body composition, diabetic peripheral neuropathy (DPN), activity level, and muscle strength (grip, knee extensor, and ankle plantar flexor strength). One-way ANOVA and multiple regression models were used to identify factors associated with the relative muscle strength.ResultsOur data showed that age, diabetes duration, fat percentage, WBC, DPN, and DKD were negatively associated with the relative muscle strength. Specifically, a greater WBC was associated with lower relative muscle strength of both distal and proximal muscle groups of extremities after the adjustment of other associated factors. DPN was associated with lower relative strength of the distal muscle groups of extremities.ConclusionsWBC may be used as a marker of inflammation, and greater count, even within the normal range, is negatively associated with the relative muscle strength in patients with T2DM.     

内源分泌型晚期糖基化终末产物受体与糖尿病周围神经病变的相关性

目的 探讨2型糖尿病患者周围神经病变(DPN)与内源分泌型晚期糖基化终末产物受体(esRAGE)的关系.方法 收集2008年6月至2009年3月于福建医科大学第二医院内分泌科住院的2型糖尿病患者61例及门诊体检的健康志愿者24名,根据有无合并糖尿病周围神经病变将糖尿病患者分2组,DPN组62例,无DPN组19例.采用酶联免疫吸附法(ELISA)测定血浆esRAGE水平.应用肌电诱发电位仪进行神经功能检查.测定受试者血压、体重指数、空腹血糖、糖化血红蛋白(HbA1c)、血脂.采用student t检验和非参数Mann-Whitney U检验分析两组问数据,利用Logistic回归分析糖尿病周围神经病变的相关因素.结果 正常对照组和2型糖尿病组患者血浆esRAGE水平无明显差别[(0.28±0.13)μg/L和(0.25±0.15)μg/L,P＞0.05],但在2型糖尿病患者中合并DPN组和无合并DPN组之间血浆esRAGE水平差别有显著性意义[(0.21±0.14)μg/L和(0.33±0.13)μg/L,P＜0.01],两组之间的年龄和糖化血红蛋白(HbA1c)也存在差别,Logistic回归分析提示年龄、HbA1c、血浆esRAGE水平与糖尿病周围神经病变相关,esRAGE是糖尿病周围神经病变保护因素(OR=0.001,P＜0.05).结论 2型糖尿病患者血浆esRAGE水平和正常人无明显差别.esRAGE是2型糖尿病周围神经病变的保护因素,而年龄和HbAlc是其危险因素.     

血清25羟维生素D缺乏与2型糖尿病周围神经病变的相关性

目的 探讨血清25羟维生素D[25（OH）D]缺乏与糖尿病周围神经病变（DPN）的关系.方法 DPN患者（DPN组）76例、T2DM未合并DPN患者（T2DM组）70例以及正常对照者（NC组）50名.采用ECLIA测定血清25（OH）D水平,并进行3组间比较. 结果 DPN组25（OH）D水平（30.55±8.95） nmol/L低于T2DM组（58.86±15.79） nmol/L和NC组（60.10±6.63） nmol/L（P＜0.01）.相关分析显示,HbA1 c、TC、LDL-C与25（OH）D水平均呈负相关（P＜0.05）;二元Logistic回归分析显示,25（OH）D缺乏与DPN相关（OR=1.212,P=0.000）. 结论 25（OH）D缺乏是DPN的独立危险因素.     

The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country

ABSTRACT: Prevalence of diabetes mellitus (DM) has reached epidemic proportions in Sri Lanka. Presently there are studies on the community prevalence of distal peripheral neuropathy (DPN) in Sri Lanka. We describe prevalence, patterns and predictors of DPN in patients with DM in Sri Lanka. Data were collected as part of a national study on DM. In new cases DPN was assessed using the Diabetic-Neuropathy-Symptom (DNS) score, while in those with established diabetes both DNS and Toronto-Clinical-Scoring-System (TCSS) were used. A binary logistic-regression analysis was performed with 'presence of DPN' as the dichomatous dependent variable and other independent co-variants. The study included 528 diabetic patients (191-new cases), with a mean age of 55.0?±?12.4?years and 37.3% were males, while 18% were from urban areas. Prevalence of DPN according to DNS score among all patients, patients with already established diabetes and newly diagnosed patients were 48.1%, 59.1% and 28.8% respectively. Prevalence of DPN in those with established DM as assessed by TCSS was 24% and the majority had mild DPN (16.6%). The remainder of the abstract is based on subjects with established DM. The prevalence of DPN in males and female was 20.0% and 26.4% respectively. The mean age of those with and without DPN was 62.1?±?10.8 and 55.1?±?10.8?years respectively (p?相似文献   

Transforming growth factor beta 1 as a biomarker of diabetic peripheral neuropathy: cross-sectional study

BackgroundSimple and efficient screening methods are lacking for diabetic peripheral neuropathy (DPN), the most common and most difficult to treat of the long-term diabetic complications. Increased levels of transforming growth factor beta 1 (TGFβ1) in type 2 diabetic patients (T2DM) plays an immunomodulatory role in diabetic nephropathy and, possibly, in atherosclerotic evolution. Since preliminary interrelationships between experimental DPN and TGFβ1 have been observed, we sought to assess whether TGFβ1 could be a biomarker molecule for human DPN.Materials and MethodsCross-sectional cohort study focused on the assessment of the interrelationships between TGFβ1 levels, cardiovascular disease (CVD), diabetic nephropathy (DNF), and neuropathy (DPN) in a group of T2DM patients (N=180; male 117, female 63) randomly selected from the North Catalonia Diabetes Study. DPN was diagnosed using clinical and neurophysiology evaluation. Incipient DNF was assessed by microalbuminuria (MAU). Total TGFβ1 (without acidification) was measured by immunoassay by ELISA (Promega).ResultsDPN correlated with age, time of diabetes duration, MAU, CVD, and TGFβ1 (P<.0001). Log-transformed TGFβ1 (logTGβ1) was significantly higher in patients with DPN than in those without (P<.0005). LogTGFβ1 (OR=7.5; P=.006), age (OR=1.1; P<.0005), and logMAU (OR=2.0; P=.016) appear as significant estimators of the occurrence of DPN in our series. The integrated ROC curve evaluation with these three parameters expressed an important sensitivity (78.1%), specificity (76.0%), positive predictive value (79.2%), and negative predictive value (70.3%) in relation to DPN presence.DiscussionTGFβ1 stands as an important biomarker molecule for DFN and DPN screening in our series. Further prospective studies are warranted.     

2型糖尿病周围神经病变患者血清脑源性神经营养因子水平的变化及临床意义

目的 探讨脑源性神经营养因子（BDNF）与T2DM及糖尿病周围神经病变（DPN）的相关性及临床意义. 方法 选取T2DM患者102例,根据DPN诊断标准分为DPN组60例和单纯T2DM组42例.另选取健康体检者97名作为正常对照（NC）组,对各组BDNF表达水平变化的相关因素进行Pearson相关分析及多因素线性回归分析. 结果 （1）与单纯T2DM组和NC组比较,DPN组BMI、FPG、胰岛素抵抗指数（HOMA-IR）升高（P＜0.05或P＜0.01）,BDNF表达水平降低（P＜0.01）.（2）T2DM患者中,女性BDNF表达水平高于男性（P＜0.05）.（3）多因素线性回归分析显示,糖尿病病程、感觉阈值与BDNF表达水平相关.Pearson相关性分析显示,血清BDNF表达水平与HOMA-IR呈负相关性（P＜0.05）. 结论 T2DM患者外周血BDNF表达水平下降,BDNF表达水平与感觉阈值、病程及HOMA-IR负相关.