2型糖尿病足部振动感觉损伤相关危险因素分析

目的 研究2型糖尿病足部振动感觉损伤相关危险因素.方法 用振动感觉分析仪对3270名2型糖尿病患者行振动感觉检查,分为振动感觉减退的研究组及无振动感觉减退的对照组,测定尿蛋白、血脂、体重指数、血糖、HbA_(1C)、血清果糖胺、C肽、血压等及眼底检查.结果 研究组年龄平均为(59±12)岁,病程≥5年、24 h尿蛋白定量≥300 mg/d、有糖尿病视网膜病变、足部症状及男性比例均高于对照组,空腹血清C肽(0.56±0.45)nmol/L、餐后2 hC肽(1.81±0.95)nmol/L均低于对照组(0.65±0.56)和(2.14±0.82)nmoL/L,P<0.05].Loistic回归分析显示,足部症状、24 h尿蛋白定量、糖尿病病程与振动感觉减退明显相关.结论 24h尿蛋白量、糖尿病病程、足部症状是2型糖尿病振动感觉损伤的危险因素.

Analysis of risk factors related to decreased feet vibration perception in type 2 diabetic patients

Objective To study the risk factors of decreased feet vibration perception in type 2 diabetic patients.Methods Three thousand two hundred and seventy patients with type 2 diabetes were divided into 2 groups according to the results of vibration perception test:group A with decreased vibration perception and group B with normal perception as control. Urinary protein content,lipid profile,body mass index,blood glucose,HbA_(1C),plasma fruetosamine,C-peptide,and blood pressure were measured,and ocular fundus were examined.Results The subiects in group A were older than those in group B(59±12)vs(56±12)years,P<0.05].The percentage of longer diabetes duration(≥5 years),24 h urinary protein content≥300 mg/d,combined diabetic retinopathy,foot symptorms and male sex were higher in group A than those in group B.Fasting and postprandial C-peptide levels(0.56±0.45 and 1.81±0.95)nmol/L]in group A were lower than those in group B(0.65±0.56and 2.14±0.82)nmol/L,P<0.05].Logistic regression analysis showed that the independent risk factors of decreared feet vibration perception in type 2 diabetic patients were 24 h urinary protein,foot symptoms and duration of diabetes.Conclusion 24 h urinary protein content,duration of diabetes,and foot symptoms seem to be the most important risk factors related to decreased vibration perception in type 2 diabetes.