血清铁蛋白与2 型糖尿病周围神经病变的 相关性分析

Correlation analysis between serum ferritin and peripheral neuropathy in type 2 diabetic patients

摘要:

目的 探讨血清铁蛋白（SF）与2 型糖尿病（T2DM）周围神经病变（DPN）的相关性。方法 选取 2016 年1 月-2016 年12 月该院T2DM 患者150 例，将其分为糖尿病无周围神经病变组（T2DM 组）66 例，糖 尿病周围神经病变组（DPN 组）84 例，同时选择健康体检者30 例作为对照组（NC 组）。测定各组血清SF 与空 腹血糖（FPG）、餐后2 h 血糖（2 hPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、高密 度脂蛋白（HDL）、低高密度脂蛋白（LDL）、同型半胱胺酸（Hcy）及空腹胰岛素（FINS）；评价胰岛素抵抗指数 （HOMA-IR）、胰岛β 细胞分泌指数（HOMA-IS），并分析血清SF 与相关指标的关系。结果 ① 3 组舒张压（DBP）、 FPG、2 hPG、HbA1c、TC、TG、LDL、FINS 及Hcy 比较，差异有统计学意义（P <0.05）；DPN 组与T2DM 组FPG、2 hPG、HbA1c、TG、FINS 及Hcy 均呈逐渐增高趋势（P <0.05）。3 组HOMA-IR、HOMAIS 比较，差异有统计学意义（P <0.05）；3 组HOMA-IR 逐渐增高，而HOMA-IS 逐渐降低。② 3 组血清SF 水平比较，差异有统计学意义（P <0.05）；DPN 组血清SF 水平>T2DM 组>NC 组。③血清SF 与HbA1c、 HOMA-IR 及Hcy 呈正相关（rs =26.600、14.055 及9.513，P =0.000、0.000 及0.043），与HOMA-IS 呈负相关（rs = -0.895，P =0.004）。④多元线性回归分析显示，SF、Hcy、2 hPG、TG、FINS、HOMA-IR 及HOMA-IS 是 DPN 的危险因素（P <0.05）。结论 血清SF 水平的升高与血糖、血脂代谢紊乱、胰岛素抵抗及氧化应激有关， 其共同参与DPN 的发生、发展。

Abstract:

Objective To investigate correlation between serum ferritin (SF) level and diabetic peripheral neuropathy (DPN) in type 2 diabetic patients. Methods A total of 150 patients with type 2 diabetes admitted to department of Endocrinology in our hospital from January 2016 to December 2016 were divided into two groups: 84 cases with DPN (DPN group) and 66 cases without DPN (T2DM group), with 30 healthy subjects (NC group). Serum ferritin (SF), fasting blood glucose (FPG), 2-hour postprandial glucose (2h PG), hemoglobin A1c (HbA1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), homocysteine (Hcy) and fasting insulin (FINS) were measured. Insulin resistance index (HOMA-IR) and islet cell secretory index (HOMA-IS) were also evaluated and SF and related factors were analysed. Results The levels of DBP (diastolic blood pressure). ① FPG, 2 hPG, HbA1c, TC, TG, LDL, Fins and Hcy in T2DM group and DPN group were statistically significant different (P < 0.05). With the development of diabetic peripheral neuropathy, the levels of FPG, 2 hPG, HbA1c, TG, Fins and Hcy in DPN group showed an increasing trend than those in T2DM group (P < 0.05). Compared with NC group, the leves of HOMA-IR and HOMA-IS were statistically significant different in T2DM group and DPN group (P < 0.05); HOMA-IR gradually increased, and HOMA-IS decreased gradually. ② Among the 3 groups, SF was the highest in group DPN and the lowest in group NC, with statistically significant difference (P < 0.05). ③ Correlation analysis showed that SF was positively correlated with HbA1c, HOMA-IR and Hcy (r = 26.600, 14.055 and 9.513, P = 0.000, 0.000 and 0.043), but negatively correlated with HOMA-IS (r = -0.895, P = 0.004). ④ Multivariate linear regression analysis showed that SF, Hcy, 2 hPG, TG, Fins, HOMA-IR and HOMA-IS were independent risk factors of DPN. Conclusions Increase of SF level is related to blood glucose, blood lipid metabolism disorder, insulin resistance and oxidative stress. They are involved in the occurrence and development of DM and DPN.