C肽质量浓度与2型糖尿病神经病变的相关性研究  

Relationship of C-peptide levels and neuropathy in type 2 diabetes mellitus

作　　者：卢丙艳 董静莲 

机构地区：[1]天津市红桥医院内分泌消化科,天津300130

出　　处：《首都医科大学学报》2018年第1期133-137,共5页Journal of Capital Medical University

摘　　要：目的探讨2型糖尿病(type 2 diabetes mellitus,T2DM)患者血清C肽(C-peptide,C-P)质量浓度与神经病变的关系。方法回顾性分析426名T2DM患者的临床资料,根据其血清C-P质量浓度分为3组,由低到高分别为C-P1(≤1.7μg/L)152例,C-P2(1.8~2.7μg/L)137例,C-P3(≥2.8μg/L)137例。结果低C-P组体质量指数(body mass index,BMI)、三酰甘油(triglyceride,TG)、尿酸(uric acid,UA)、空腹胰岛素(fasting insulin,FINS)质量浓度低于高C-P组(P<0.05),高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、病程、糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)和糖尿病心脏自主神经病变(diabetic cardiac autonomic neuropathy,DCAN)发病率高于高C-P组,且C-P质量浓度越低,合并症发病率越高(P<0.05)。DPN及DCAN患者的血清C-P质量浓度均低于非糖尿病周围神经病变(nondiabetic peripheral neuropathy,NDPN)及非糖尿病心脏自主神经病变(nondiabetic cardiac autonomic neuropathy,NDCAN)患者(P<0.05)。C-P质量浓度与BMI、TG、UA、FINS浓度正相关(P<0.05),与HDL、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、空腹血糖(fasting plasma glucose,FPG)、病程、DPN发病率、DCAN发病率呈负相关(P<0.05)。Logistic回归分析显示,在校正了相关因素后,病程和较低的C-P质量浓度是糖尿病神经病变发生的独立危险因素。结论血清C-P质量浓度是T2DM周围神经病变和心脏自主神经病变的独立相关因素。Objective To investigate the relationship between the level of serum C-peptide（ C-P） and neuropathy in patients with type2 diabetes mellitus（ T2 DM）. Methods The clinical data of 426 patients with T2 DM was retrospectively analyzed. These patients were divided into three groups according to their serum C-P levels. From low to high were C-P（ ≤1. 7 μg/L） in 152 cases,C-P2（ 1. 8-2. 7μg/L） in 137 cases,C-P3（ ≥2. 8 μg/L） in 137 cases. Results The levels of body mass index（ BMI）,triglyceride（ TG）,uric acid（ UA） and fasting insulin（ FINS） in the group of low C-P were lower than those in high C-P group（ P〈0. 05）. The levels of high density lipoprotein cholesterol（ HDL-C）,course and the incidence of diabetic peripheral neuropathy（ DPN） and diabetic cardiac autonomic neuropathy（ DCAN） were higher than those in high C-P group. The lower level of C-P,the higher incidence of complications（ P〈0. 05）.Serum C-P levels in patients with DPN and DCAN were lower than those of nondiabetic peripheral neuropathy（ NDPN） and nondiabetic cardiac autonomic neuropathy（ NDCAN）（ P〈0. 05）. The level of C-P was positively related to the levels of BMI,TG,UA and FINS（ P〈0. 05）,and negatively related to HDL-C,low density lipoprotein cholesterol（ LDL-C）,fasting plasma glucose（ FPG）,course,incidence of DPN and DCAN（ P〈0. 05）. Logistic regression analysis showed that the course and the low level of C-P were independent risk factors of diabetic neuropathy complications after correction of related factors. Conclusion Serum C-P level is independently associated with peripheral neuropathy and cardiac autonomic neuropathy in T2 DM.

关 键 词：2型糖尿病 周围神经病变 心脏自主神经病变 C肽 

分 类 号：H587.1[语言文字]