临床氧化应激指标与糖尿病周围神经病变的相关研究

Correlation between clinical oxidative stress and diabetic peripheral neuropathy

摘要:

目的 调查2型糖尿病患者的临床氧化应激指标情况,分析其与2型糖尿病患者伴发周围神经病变的相关性。方法 收集2016年10月至2017年5月解放军第306医院内分泌科同期住院的212例2型糖尿病患者一般资料及临床资料。根据2型糖尿病患者伴发周围神经病变诊断标准,将入选患者分为伴发周围神经病变(n=97)和未伴发周围神经病变(n=115)2组。应用SPSS 23.0对2组患者的一般情况及临床资料进行比较,采用logistic 回归分析2型糖尿病患者伴发周围神经病变的危险因素。探讨2型糖尿病患者伴发周围神经病变的特点及其与临床氧化应激指标的相关性。结果 2型糖尿病患者伴发周围神经病变组患者年龄、病程、糖化血红蛋白、总胆固醇显著高于未伴发周围神经病变组患者,空腹C肽、血红蛋白和总胆红素显著低于2型糖尿病非周围神经病变组患者(P<0.05)。单因素logistic回归分析显示年龄、病程、糖化血红蛋白、总胆红素、血红蛋白可能与2型糖尿病患者伴发周围神经病变相关,进一步多因素logistic回归分析显示病程(OR=1.006,95%CI 1.003~1.010)、糖化血红蛋白(OR=1.403,95%CI 1.118~1.657)、血红蛋白(OR=0.976,95%CI 0.958~0.994)是2型糖尿病患者伴发周围神经病变的独立危险因素。结论 2型糖尿病患者伴发周围神经病变患者临床氧化应激指标(总胆红素、血红蛋白)低于2型糖尿病非周围神经病变患者,且具有高龄、糖尿病病程长、血糖控制不佳及胰岛功能差的特点。

Abstract:

Objective To investigate the relationship between diabetic peripheral neuropathy and clinical indicators of oxidative stress in the patients with type 2 diabetes mellitus. Methods General and clinical data were collected of patients hospitalized from 2016 to 2017 with type 2 diabetes mellitus in our hospital. The patients were divided into group A with peripheral neuropathy (n=97) and group B (n=115) without. The two groups were compared in general and clinical data using SPSS statistics 23.0, and logistic regression was employed to analyze the risk factors for diabetic peripheral neuropathy. The characteristics of diabetic peripheral neuropathy and its correlation with clinical indicators of oxidative stress were investigated. Results The age, disease duration, glycosylated hemoglobin A1c and total cholesterol were significantly higher in group A than in group B, while fasting C peptide, hemoglobin and total bilirubin was significantly lower in the former than in the latter (P<0.05). The univariate logistic regression model revealed that age, disease duration, glycosylated hemoglobin A1c, total bilirubin and hemoglobin might be associated with diabetic peripheral neuropathy. The multivariate logistic regression analysis showed that disease duration (OR=1.006,95%CI 1.003-1.010), glyco-sylated hemoglobin A1c (OR=1.403,95%CI 1.118-1.657), hemoglobin (OR=0.976,95%CI 0.958-0.994) were significant risk factors for diabetic peripheral neuropathy. Conclusion Patients with diabetic peripheral neuropathy have lower clinical indicators of oxidative stress (total bilirubin and hemoglobin) than those without, the former being more advanced in age, having long duration of diabetes, poorer blood glucose control, and poorer islet function.