A study of the Relationship between Serum Serum 25(OH)D,CysC,NLR,PLR and the Development of Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus Combined with Hashimoto's Thyroiditis
Objective:To investigate the relationship between serum 25-hydroxyvitamin D[25(OH)D],cystatin C(CysC),neu-trophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and diabetic peripheral neuropathy(DPN)in patients with type 2 dia-betes mellitus(T2DM)combine with Hashimoto's thyroiditis(HT).Methods:150 patients with T2DM combine with HT who were ad-mitted to the Endocrinology Department of Hefei Second People's Hospital from January 2020 to January 2023 were selected as T2DM combine with HT group,and 150 patients with simple T2DM during the same period were selected as simple T2DM group,patients with T2DM combine with HT were divided into DNP group(n=93)and non-DNP group(n=57)according to whether DNP occurred.Serum 25(OH)D,CysC,NLR and PLR were detected and calculated,the influencing factors of DNP in patients with T2DM combine with HT were analyzed by multivariate logistic regression,the predictive value of serum 25(OH)D,CysC,NLR and PLR for DNP in patients with T2DM combine with HT were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with simple T2DM group,the serum 25(OH)D level decreased and serum CysC,NLR and PLR increased in T2DM combined with HT group,and the difference was statistically significant(P＜0.05).The incidence of DNP in 150 patients with T2DM combine with HT was 62.00％(93/150).Multi-variate logistic regression analysis showed that,prolonged course of T2DM and elevated levels of glycosylated hemoglobin(HbA1c),thyroid stimulating hormone(TSH),CysC,NLR and PLR were independent risk factors for DNP in patients with T2DM combine with HT,and elevated level of 25(OH)D was an independent protective factor(P＜0.05).ROC curve analysis showed that,the area under the curve of serum 25(OH)D,CysC,NLR and PLR combined to predict DNP in patients with T2DM combine with HT was 0.920,which was greater than that of serum 25(OH)D,CysC,NLR and PLR alone.Conclusion:The decrease of serum 25(OH)D level and the increase of CysC,NLR and PLR in patients with T2DM combine with HT,which are independent influencing factors of DNP in patients with T2DM combine with HT,the combination of serum 25(OH)D,CysC,NLR and PLR has a high predictive value for DNP in patients with T2DM combine with HT.
Type 2 diabetes mellitusHashimoto's thyroiditis25(OH)DCysCNLRPLRDiabetic peripheral neuropathy
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