摘要
目的 观察2型糖尿病(T2DM)患者血清网膜素-1(omentin-1)、脂肪细胞因子Apelin表达情况,并探讨二者与周围神经病变的关系.方法 回顾性纳入2019年6月至2022年6月期间在三亚中心医院(海南省第三人民医院)接受诊治的245例T2DM患者作为研究对象,根据患者是否合并周围神经病变将其分为周围神经病变组(n=147)和非周围神经病变组(n=98).收集两组患者的一般资料[性别、年龄、体重指数、病程、收缩压、舒张压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹血糖、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)].采用酶联免疫吸附试验法检测两组患者的血清omentin-1、Apelin水平;采用Pearson相关分析对T2DM周围神经病变患者血清omentin-1、Apelin水平与一般资料的相关性进行分析;绘制血清omentin-1、Apelin诊断T2DM周围神经病变的受试者操作特征(ROC)曲线,评价血清omentin-1、Apelin水平对T2DM周围神经病变的诊断效能;采用多因素Logistic回归分析对T2DM患者发生周围神经病变的影响因素进行分析.结果 周围神经病变组患者的病程、HbA1c、空腹血糖、HOMA-IR水平分别为(6.34±1.86)年、(9.83±2.01)％、(10.24±2.25)mmol/L、1.28±0.39,均明显高于非周围神经病变组[(4.72±1.31)年、(7.64±1.36)％、(8.76±2.13)mmol/L、0.93±0.27],差异均有统计学意义(P＜0.05).周围神经病变组患者的血清Apelin水平为(14.76±3.89)ng/mL,明显高于非周围神经病变组[(22.31±4.25)ng/mL],血清o mentin-1水平为(937.85±210.42)pg/dL,明显低于非周围神经病变组[(686.19±119.28)pg/dL],差异均有统计学意义(P＜0.05).Pearson相关分析结果显示,T2DM周围神经病变患者血清omentin-1水平与病程、空腹血糖、HbA1c、HOMA-IR呈负相关(P＜0.05),Apelin水平与病程、空腹血糖、HbA1c、HOMA-IR呈正相关(P＜0.05).血清omentin-1、Apelin单独及联合诊断T2DM周围神经病变的曲线下面积(AUC)分别为 0.786、0.808、0.882,敏感度分别为 73.6％、58.6％、80.9％,特异度分别为 75.2％、92.4％、86.1％.多因素Logistic回归分析结果显示,血清Apelin是T2DM患者并发周围神经病变的独立危险因素(P＜0.05),血清omentin-1是T2DM患者并发周围神经病变的保护因素(P＜0.05).结论 血清o mentin-1、Apelin水平可用于评估T2DM患者并发周围神经病变的风险.
Abstract
Objective To observe the expressions of serum omentin-1 and adipocytokine Apelin in patients with type 2 diabetes mellitus(T2DM),and to explore their relationship with peripheral neuropathy.Methods A total of 245 T2DM patients who were diagnosed and treated in Sanya Central Hospital(Hainan Third People's Hospital)from June 2019 to June 2022 were retrospectively included as the research objects,and they were divided into the peripheral neuropathy group(n=147)and the non peripheral neuropathy group(n=98)according to whether the patients were complicated with peripheral neuropathy.The general data[gender,age,body mass index,course of disease,systolic and diastolic blood pressure,triglycerides,total cholesterol,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(LDL-C),hemoglobin A1c(HbA1c),fasting blood glucose,fasting insulin(FINS),insulin resistance index(HOMA-IR)]of two groups of patients were collected.The serum omentin-1 and Apelin levels were detected using Enzyme-linked immunosorbent assay.The correlation between serum omentin-1 and Apelin levels and general data in patients with T2DM peripheral neuropathy were analyzed using Pearson correlation;the receiver operating characteristic(ROC)curve of serum omentin-1 and Apelin in the diagnosis of T2DM peripheral neuropathy was drawn,the diagnostic efficacy of serum omentin-1 and Apelin levels in peripheral neuropathy of T2DM were evaluated;the influencing factors of peripheral neuropathy in T2DM patients was analyzed using multivariate Logistic regression.Results The disease course,HbA1c,fasting blood glucose,and HOMA-1R levels of patients in the peripheral neuropathy group were(6.34±1.86)years,(9.83±2.01)％,(10.24±2.25)mmol/L,and 1.28±0.39,respectively,which were significantly higher than those in the non peripheral neuropathy group[(4.72±1.31)years,(7.64±1.36)％,(8.76±2.13)mmol/L,and 0.93±0.27],and the differences were statistically significant(P＜0.05).The level of serum Apelin in the pe-ripheral neuropathy group was(14.76±3.89)ng/mL,which was obviously higher than those in the non peripheral neuropathy group[(22.31±4.25)ng/mL],and serum omentin-1 level was(937.85±210.42)pg/dL,which was obviously higher than that in the non peripheral neurop-athy group[(686.19±119.28)pg/dL],and the differences were statistically significant(P＜0.05).The results of Pearson correlation showed that serum omentin-1 was negatively correlated with disease course,fasting blood glucose,HbA1c,and HOMA-IR in T2DM peripheral neu-ropathy patients(P＜0.05),and Apelin was positively correlated with disease course,fasting blood glucose,HbA1c,and HOMA-IR(P＜0.05).The area under the curve(AUC)of omentin-1 and Apelin alone and in combination in the diagnosis of peripheral neuropathy in T2DM was 0.786,0.808,and 0.882,respectively,with sensitivity of 73.6％,58.6％,and 80.9％,respectively,and specificity of 75.2％,92.4％,and 86.1％,respectively.The results of multivariate Logistic regression showed that serum Apelin was an independent risk factor for peripheral neuropathy in T2DM patients(P＜0.05),while serum omentin-1 was a protective factor for peripheral neuropathy in T2DM patients(P＜0.05).Conclusion Serum omentin-1 and Apelin can be used to evaluate the risk of peripheral neuropathy in patients with T2DM.
基金项目
海南省卫生健康科技创新联合项目(SQ2023WSJK00060)
维普
万方数据