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

作　　者：喻昆林[1] 范佳双 刘书言 Kun-lin Yu;Jia-shuang Fan;Shu-yan Liu(Department of Endocrinology,the Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院内分泌科,云南昆明650101

出　　处：《中国现代医学杂志》2018年第27期98-102,共5页China Journal of Modern Medicine

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。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).①FPG,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.②Among the 3 groups,SF was the highest in group DPN and the lowest in group NC,with statistically significant difference(P<0.05).③Correlation 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).④Multivariate 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.

关 键 词：2型糖尿病 周围神经病变 血清铁蛋白 

分 类 号：R587.1[医药卫生—内分泌]