关于2型糖尿病并发末梢神经病变危险因素的病例对照研究

糖尿病末梢神经病变(Diabetic Peripheral Neuropathy,DPN)是糖尿病常见并发症之一,不仅本身严重危害健康,有很高的病死率,而且与其他慢性并发症的发生发展关系密切。目的探讨2型糖尿病病人并发DPN的危险因素。方法采用以医院为基础的1:1配对病例对照研究方法。运用条件Logistic回归分析,建立主效应方程分析讨论DPN的危险因素。结果单因素Logistic回归分析表明,DPN发生的保护性因素包括:文化程度高、治疗方法力度大、现患冠心病、饮茶;危险因素包括:糖尿病病程长、血糖控制(HbAlc%)不良、使用胰岛素、合并糖尿病肾病、合并糖尿病视网膜病变、主诉眩晕症状、皮肤干燥、现患高血压、既往酮症、患糖尿病前肉类食物的摄入较多、既往吸烟(调查时已戒烟)、创伤经历、腰臀比WHR超标、血胆固醇(Chol)水平高。多因素Logistic回归分析示DPN发生的危险因素有6个:糖尿病病程、使用胰岛素、主诉眩晕症状、糖尿病前肉类食物摄入较多、饮酒以及既往创伤经历(手术、冻伤等)。结论DPN与多种因素相关,在2型糖尿病患者中,糖尿病病程长、使用胰岛素、主诉眩晕症状、糖尿病前肉类食物摄入较多、饮酒、既往创伤史会增加糖尿病神经病变的发生危险,我们应在DPN的防治过程中特别予以注意。

Case - controlled Study of Risk Factors of Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus

Objective The present study was aimed to identify the risk factors for the development of diabetic peripheral neuropathy(DPN) in patients with type 2 diabetes mellitus.Since DPN is one of the most common complications of DM patients that is closely related to other complications and induces multi-organ disorders. Methods A hospital-based 1:1 pair-matched case control study was conducted in the metabolic disease hospital of Tianjin Medical University.Conditional logistic regression,multivariate logistic regression model were applied to analyze the risk factors. Results Results from univariant analysis showed that the following factors were significantly associated with the development of DPN: prolonged duration of DM, poor blood sugar control(i.e.high HbAlc%),insulin treatment,diabetic nephropathy,diabetic retinopathy,history of diabetic ketonemia,excessive intake of meat before the onset of diabetes mellitus,vertigo,dryness of skin,hypertension,history of injury,high waist to hip ratio,high level of blood cholesterol(Chol),and high-education condition,aggressive DM management,coronary heart disease,and tea drinking.The results of multi-logistic analysis showed that the following factors were significantly associated with DPN: prolonged duration of DM,treatment with insulin,vertigo,high intake of meat before onset of diabetes mellitus,alcohol consumption,and the history of injury. Conclusions DPN is related with multiple risk factors.Prolonged duration of DM,treatment with insulin,vertigo,heavy intake of meat before onset of diabetes mellitus,alcohol consumption,and history of injury are risk factors of DPN in patients with type 2 diabetes mellitus.