血清缺氧诱导因子-1α、髓鞘碱性蛋白和超敏C反应蛋白在糖尿病周围神经病变中的变化及临床意义  

Changes and clinical significance of HIF-1α, MBP and hs-CRP in patients with diabetic peripheral neuropathy

作　　者：张丽[1] 罗荔[1] 陆春晖[1] 张洁[1] 王敏哲[1] ZHANG Li LUO Li LU Chunhui ZHANG Jie WANG Minzhe(Department of Endocrine, the Fifth Affiliated Hospital of Xinjiang Medical University, Xinjiang Uygur Autonomous Region, Urumqi 830011, China)

机构地区：[1]新疆医科大学第五附属医院内分泌科,新疆乌鲁木齐830011

出　　处：《中国医药导报》2017年第15期174-178,共5页China Medical Herald

基　　金：新疆维吾尔自治区自然科学基金(2016D01C241);新疆医科大学科研创新基金项目(XYDCX2015112)

摘　　要：目的检测糖尿病周围神经病变患者血清缺氧诱导因子-1α(HIF-1α)、髓鞘碱性蛋白(MBP)、超敏C反应蛋白(hs-CRP)和氧化应激反应水平,分析其相关性。方法选择2015年7月~2016年7月在新疆医科大学第五附属医院(以下简称"我院")接受治疗的糖尿病周围神经病变患者90例为研究组,选择同期在我院体检的年龄、性别相匹配的健康人群80名为对照组。检测两组一般生化指标、血清HIF-1α、MBP、hs-CRP及超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)、丙二醛(MDA)氧化应激指标水平。糖尿病周围神经病变发生的影响因素采用多因素Logistic回归分析。研究组患者血清HIF-1α、MBP、hs-CRP与SOD、GSH、MDA的相关性分析采用Spearman相关性检验。结果研究组总胆固醇(TC)、三酰甘油(TG)、空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、空腹胰岛素(FINS)水平均明显高于对照组(P﹤0.05)。研究组血清HIF-1α、MBP、hs-CRP水平均明显高于对照组,差异有统计学意义(P﹤0.05)。研究组血清SOD、GSH水平均明显低于对照组(P<0.05),MDA水平明显高于对照组(P<0.05)。多因素Logistic分析表明,年龄、糖尿病病程、TC、TG、FPG、HbA_(1c)、FINS、HIF-1α、MBP、hs-CRP、MDA是糖尿病周围神经病变发生的独立危险因素(P<0.05),SOD、GSH是糖尿病周围神经病变的保护性因素(P<0.05)。Spearman相关检验分析显示,研究组血清HIF-1α、MBP、hs-CRP均与MDA水平呈正相关(r=0.547、0.624、0.685,P<0.05),均与SOD、GSH水平呈负相关(r=-0.565、-0.583、-0.592,r=-0.492、-0.551、-0.572,均P<0.05)。结论血清HIF-1α、MBP、hs-CRP水平的上升和氧化应激反应均参与糖尿病周围神经病变的发生及发展,可能成为临床辅助诊断糖尿病周围神经病变患者的生物指标,为临床干预治疗提供理论依据。Objective To detect the levels of serum hypoxia inducible factor-1α （HIF-1α）, myelin basic protein （MBP）, high sensitive C reactive protein （hs-CRP） and oxidative stress response in patients with diabetic peripheral neuropa- thy, and analyze the correlation among them. Methods 90 cases of patients with diabetic peripheral neuropathy treated in the Fifth Affiliated Hospital of Xinjiang Medical University （＂our hospital＂ for short） from July 2015 to July 2016 were selected as the study group. 80 healthy cases matched by age and gender in our hospital at the same time were selected as the control group. General biochemical indexes, levls of serum HIF-1α, MBP, hs-CRP, oxidative stress lev- els of super oxide dismutase （SOD）, reduced glutathione （GSH）, and malonaldehyde （MDA） were detected and compared between the two gorups. The multivariate Logistic regression analysis was used to analyze the influence factors of dia- betic peripheral neuropathy. Spearman correlation test was used to analyze the correlation among serum HlF-1α, MBP, hs-CRP and SOD, GSH, MDA in the study group. Results The levels of total cholesterol （TC）, triglyceride （TG）, fasting blood glucose （FPG）, glyeosylated hemoglobin （HbA1C）, fasting insulin （FINS） in the study group were significantly higher than those in the control group （P 〈 0.05）. The levers of serum HIF-1α, MBP and hs-CRP in the study group were sig-nificantly higher than those in the control group, the differences were statistically significant （P 〈 0.05）. The levels of serum SOD and GSH in the study group were significantly lower than those in the control group （P 〈 0.05）, and the serum MDA level in the study group was significantly higher than that in the control group （P 〈 0.05）. The multivariate Logistic regression analysis showed that age, duration of diabetes, TC, TG, FPG, HbA1C, FINS, MBP, hs-CRP, HIF-1α, MDA were independent risk factors of diabetic peripheral neuropathy （P 〈 0.05）, SOD and

关 键 词：糖尿病周围神经病变 缺氧诱导因子-1Α 髓鞘碱性蛋白 超敏C反应蛋白 氧化应激反应 

分 类 号：R587.1[医药卫生—内分泌]