摘要
目的 探究糖尿病周围神经病变(DPN)患者外周血网膜素1水平、胰岛素抵抗(IR)、胰岛素β功能(HO-MA-β)、内脂素与病情严重程度的关系.方法 回顾性选取2020年6月至2022年6月安康市中心医院诊治的DPN患者56例设为DPN组,另选取同期单纯糖尿病患者64例设为糖尿病组.比较两组患者一般资料(性别、年龄、体重指数、血压)、糖脂代谢指标[糖化血红蛋白(HbA1c)、空腹血糖(FBG)、空腹胰岛素(FINS)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]、胰岛素抵抗指数(HOMA-IR)、外周血网膜素1、HOMA-β及内脂素水平,并以多伦多临床周围神经评分量表(TCSS)评分评估DPN病情严重程度.以Pearson相关性及多元线性回归分析外周血网膜素1与IR、HOMA-β、内脂素及病情严重程度的关系.结果 两组患者的性别、年龄、体重指数、收缩压、舒张压、HbA1c、FBG、FINS、总胆固醇、甘油三酯、HDL-C、LDL-C值比较,差异均无统计学意义(P＞0.05).DPN 组患者外周血网膜素 1、HOMA-β 及内脂素水平分别为(14.06±2.21)ng/mL、1.08±0.36、(1.28±0.52)μg/L,均低于糖尿病组[(21.82±3.42)ng/mL、1.68±0.59、(2.45±0.98)μg/L],HOMA-IR 值为 2.16±0.49,高于糖尿病组(1.62±0.52),差异均有统计学意义(P＜0.05).Pearson相关性分析显示,DPN患者外周血网膜素1与HOMA-IR、TCSS评分呈显著负相关(r=-0.409、-0.716,P＜0.05),与HOMA-β、内脂素均呈正相关(r=0.424、0.621,P＜0.05);线性回归分析显示,HOMA-β、内脂素均为网膜素1的正向影响因素(B=2.599、2.638,P＜0.05),HOMA-IR、TCSS评分为网膜素1的负向影响因素(B=-2.911、-0.190,P＜0.05).二元Logistic回归分析显示,网膜素1、HOMA-IR、HOMA-β及内脂素均为DPN发生的影响因素(P＜0.05).结论 DPN组患者外周血网膜素1水平明显增高,网膜素1与IR、HOMA-β、内脂素及DPN病情严重程度均关系密切,网膜素1可能通过IR、HOMA-β及内脂素参与DPN的发病过程.
Abstract
Objective To explore the relationship between peripheral blood Omentin-1 levels and insulin resistance(IR),insulin beta function(HOMA-beta),visfatin(Visfatin)and disease severity in diabetic peripheral neuropathy(DPN)patients.Methods Fifty-six cases of DPN patients diagnosed and treated in Ankang Central Hospital from June 2020 to June 2022 were retrospectively selected as the DPN group,and 64 cases of simple diabetic patients in the same period were also selected as the diabetes mellitus group.The general information(gender,age,body mass index,blood pressure),glycolipid metabolic indexes[glycosylated hemoglobin(HbA1c),fasting blood glucose(FBG),fasting insulin(FINS),total cholesterol,triglycerides,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)],and insulin resistance index(HOMA-IR),peripheral blood Omentin-1,HOMA-β and visfatin levels were compared between the two groups,and the toronto clinical peripheral nerve score scale(TCSS)was used to evaluate the condition of DPN severity.The relationship between peripheral blood Omentin-1 and IR,HOMA-β,visfatin and disease severity was analyzed by Pearson correlation and multiple linear regression.Results There were no statistically significant differences in the comparison of gender,age,body mass index,systolic blood pressure,diastolic blood pressure,HbA1c,FBG,FINS,total cholesterol,triglyceride,HDL-C,and LDL-C values between the two groups(P＞0.05).The levels of peripheral blood omentin 1,HOMA-β and visfatin in DPN group were(14.06±2.21)ng/mL,1.08±0.36,(1.28±0.52)μg/L,respectively,which were lower than those in diabetes mellitus group[(21.82±3.42)ng/mL,1.68±0.59,(2.45±0.98)μg/L],and the HOMA-IR value was 2.16±0.49,which was higher than that in diabetes mellitus group(1.62±0.52),the differences were statistically signif-icant(P＜0.05).Pearson correlation analysis showed that Omentin-1 in peripheral blood of DPN patients was significantly negatively correlated with HOMA-IR and TCSS scores(r=-0.409,-0.716;P＜0.05),and positively correlated with HOMA-β and visfatin(r=0.424,0.621;P＜0.05);linear regression analysis showed that HOMA-β and visfatin were both positive influencing factors of Omentin-1(B=2.599,2.638;P＜0.05).TCSS score was a negative influencing factor of Omentin-1(B=-2.911,-0.190;P＜0.05).Binary Logistic regression analysis showed that Omentin-1,HOMA-IR,HOMA-β and visfatin were all influencing factors of DPN(P＜0.05).Conclusion The peripheral blood Omentin-1 level is significantly higher in the DPN group,and Omentin-1 is closely related to IR,HOMA-β,endosta-tin,and the severity of DPN,and Omentin-1 may be involved in the pathogenesis of DPN through IR,HOMA-β,and endostatin.
基金项目
陕西省教育厅专项科研计划项目(2021JM-231)
NETL
NSTL
万方数据