Study on mechanism of nerve fiber injury in diabetic neuropathy
Objective To explore the relationship between different nerve fiber injuries and the high sensitivity C reactive protein,to identify the type of nerve fiber injuries in patients with type 2 diabetic peripheral neuropath by the sensory nerve quantitative detector.Methods The study enrolled 246 participants with type 2 diabetes admitted in Endocrine Depart-ment of The Second Artillery General Hospital PLA from March,2020 to December,2021.The participants were divided in-to 4 groups according to their medical history,clinical symptoms,signs and the performance of diabetic peripheral neuropa-thy,combined with the quantitative sensory detector test results.The patients were divided into Group without peripheral neuropathy(60 cases),Group with coarse myelinated nerve fibers lesion(60 cases),Group with fine myelinated nerve fi-bers lesion(59 cases)and Group without myelinated nerve fibers lesion(59 cases).All of the patients'gender,age,blood pressure,body mass index(BMI),duration of diabetes and blood biochemical values were obtained.The changes of high sensitivity C reactive protein were observed between groups.And the analysis of variance and multiple x2test were adopted for the comparison between groups.Then,all subjects were evaluated based on Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS).Results hs-CRP was(5.76±5.21)mg/L in crude pulp group,(4.07±3.77)mg/L in fine pulp group,(3.83±3.49)mg/L in non-pulp group and(2.75±2.34)mg/L in non-neuropathy group,respectively.hs-CRP in coarse pulp group was significantly higher than that in fine pulp group,no pulp group and no neuropathy group(P＜0.05).The CPT of each group was(20.16±6.64)in the coarse pulp group,(16.78±4.66)in the fine pulp group,(17.02±4.61)in the non-pulp group,and(9.19±1.85)in the non-neuropathy group,which was significantly higher in the neuropathy group than in the non-neuropathy group(P＜0.05).There were no significant differences in CPT among neuropathy groups(P＞0.05).Two-factor correlation analysis indicated that hs-CRP was positively correlated with CPT in the crude pulp group(r value=0.885,P＜0.01).SDS and SAS in the crude pulp group were(32.8±9.4)and(31.2±9.9),respectively.Fine pulp group(43.8±8.2),(42.2±8.6);No pulp group(50.6±10.8),(50.6±10.8);without neuropathy group(52.3±11.5),(51.0±11.6).Conclusion hs-CRP may play a role in the pathogenesis of coarse myelinated nerve fibers lesions.The peripheral neuropathy of coarse myelinated nerve fiber damage in type 2 diabetic may be associated with vascular injuries.
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