血清白介素-17与2型糖尿病周围神经病变的相关性研究

目的 探讨2型糖尿病周围神经病变患者外周血白细胞介素-17(IL-17)的浓度变化及其临床意义.方法 选取131例2型糖尿病(T2DM)患者,分为糖尿病无神经病变组(NDPN组)46例和糖尿病周围神经病变组(DPN组)85例.另选择40例健康人群作为对照组(NC组).根据多伦多评分结果,将DPN组分为三组:DPN轻症组(DPN1组)52例,DPN中症组(DPN2组)19例和DPN重症组(DPN3组) 12例,检测外周血IL-17含量,比较各组间IL-17水平差异.结果 NDPN组、DPN组的IL-17水平较NC组显著升高, DPN组IL-17水平较NDPN组显著升高,差异有统计学意义(P＜0.05).DPN三组间的血清IL-17差异无统计学意义. Pearson相关分析显示,IL-17与年龄及踝肱比呈负相关性(r=-0. 175、-0. 284,P=0. 048、0. 022). 多元 Logistic 逐步回归分析显示,收缩压和IL-17水平越高,T2DM患者越易并发DPN.应用受试者工作特征曲线分析显示,外周血IL-17的受试者工作特征曲线下面积为0.677(95％ CI:0. 578 ～ 0. 776),最优截断点约为46. 3 pg/ml,灵敏度和特异度分别为57. 1％和73.9％.结论 2型糖尿病周围神经病变患者外周血IL-17水平明显增加,与DPN发病密切相关.血清 IL-17可作为DPN诊断的血清标志物.

Study on the correlation between serum interleukin-17 and type 2 diabetic peripheral neuropathy

Objective To investigate the relationship between serum interleukin-17(IL-17) level and diabetes peripheral neuropathy (DPN) in type 2 diabetes patients. Methods A total of 131 patients with type 2 diabetes mellitus (T2DM) were divided into 46 diabetes mellitus without neuropathy (NDPN group) and 85 with it (DPN group), and 40 healthy persons were chosen as healthy controls (NC). According to toronto clinical scoring system scores, DPN patients were classifed into mild DPN group (DPN group 1, 52 persons), medium DPN group (DPN group2, 19 persons) and severe DPN group (DPN group3, 12 persons). The serum levels of IL-17 were analysed and compared between groups. Results The levels of IL-17 in NDPN group and DPN group were significantly higher than those in NC group, Moerover the IL-17 level in DPN group was significantly higher than that in NDPN group (P ＜ 0. 05). There was no significant difference in serum IL-17 between the DPN groups. The levels of serum IL-17 was negatively correlated with age and The ankle brachial index(r =-0. 175,-0. 284;P =0. 048, 0. 022). Logistic regression analysis revealed that the prolonged disease course, higher SBP and serum IL-17 were the risk factors for DPN in T2DM patients. The area of the receiver operating characteristic curve of IL-17 in peripheral blood was 0. 677 (95％ CI:0. 578 ～0. 776). The optimal cut-off point of about 46. 3 pg/ml, and sensitivity and specificity were 57. 1％ and 73. 9％ respectively. Conclusion The level of IL-17 in peripheral blood of patients with DPN increase significantly, and is closely related to DPN. Serum IL-17 can be used as a diagnostic marker of DPN.