血浆网膜素1 与2 型糖尿病周围神经病变及其严重程度关系的研究

目的 研究2 型糖尿病（T2DM）患者血浆网膜素1（Omentin-1）水平与糖尿病周围神经病变（DPN）及其严重程度的关系。方法 选取2017 年3 月-2017 年9 符合入选标准的T2DM 患者122 例，分为单纯T2DM 患者67 例（对照组）和合并DPN 患者55 例（DPN 组）。收集患者临床资料，采用Logisitc 回归模型分析DPN 的危险因素，作受试者工作特征（ROC）曲线探索Omentin-1 诊断DPN 的效率，并应用线性回归分析Omentin-1 与评估DPN 严重程度的多伦多临床评分系统（TCSS）评分间关系。结果 ① DPN 组患者Omentin-1 水平低于对照组（P <0.05）；Omentin-1 与胰岛素抵抗系数（HOMA-IR）（r =-0.375，P =0.000）及糖化血红蛋白（HbAlc）（r =-0.445，P =0.000）呈负相关。②多因素Logistic 回归示：HbAlc[O^R=4.003（95%CI：1.016，10.776）] 和HOMA-IR[（O^R=4.595（95%CI ：1.709，12.324）] 为DPN 的危险因素；而Omentin-1[O^R=0.257（95%CI ：0.112，0.589）] 为DPN 的保护因素。③ ROC 曲线示Omenitn-1 诊断DPN 的曲线下面积为0.713（95%CI ：0.622，0.804），且当Omentin-1 切值取18.8 ng/ml 时，其诊断效率最高，敏感性为69.7%，特异性为71.8%。④ Omentin-1 与TCSS 评分负相关（r =-0.606，P =0.000）。结论 Omentin-1 是DPN 的保护因素，在T2DM 患者中可辅助DPN 诊断及其严重程度的评估。

Relationship between Omentin-1 and diabetic peripheralneuropathy

Objective To investigate the clinical relationship between serum Omentin-1 levels and diabeticperipheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 122 patientshospitalized from March 2017 to September 2017 were enrolled in this study, among which were 67 patients withT2DM (Control group) and 55 patients with DPN (DPN group). Clinical characteristics were recorded. Logisticregression model andlinear logistic analysis were performed to screen the risk factors of DPN. ROC curve wasestablished to analyze the diagnostic efficacy of Omentin-1and its association with DPN severity. Results Levelsof Omentin-1 were downregulated significantly in the DPN group compared with control group, and was negativelycorrelated with homeostatic model assessment for insulin resistance index (HOMA-IR) (r = -0.375, P = 0.000) andglycated hemoglobin (HbAlc) (r = -0.445, P = 0.001). Multivariate logistic regression analysis results revealed that HbAlc [O^R = 4.003, (95% CI: 1.016, 10.776)] and HOMA-IR [O^R = 4.595, (95% CI: 1.709, 12.324) ] wereindependent risk factors for DPN, while Omentin-1 was a protective factor of DPN [O^R = 0.257, (95% CI: 0.112,0.589) ]. ROC curve suggested that the area under the curve for Omentin-1 detecting DPN was 0.713 (95% CI:0.622, 0.804), and the optimal cut-off value was 18.8 ng/ml with sensitivity of 69.7% and specificity of 71.8%.Omentin-1 was negatively correlated with TCSS scores (r = -0.606, P = 0.000). Conclusions Omentin-1 is anindependent protective factor of DPN.