血清新喋呤、VEGF-B与新诊断2型糖尿病患者周围神经病变的相关性研究  

Study on the association between serum neopterin, VEGF-B and peripheral neuropathy in newly diagnosed patients with type 2 diabetes mellitus

作　　者：侯丽萍[1] 谷巍[1] 周立新 张雪坤[1] HOU Liping;GU Wei;ZHOU Lixin;ZHANG Xuekun(Department of Endocrinology,Hengshui Harrison International Peace Hospital,Hengshui Hebei 053000,China)

机构地区：[1]衡水哈励逊国际和平医院内分泌科,河北衡水053000

出　　处：《转化医学杂志》2022年第2期92-96,共5页Translational Medicine Journal

摘　　要：目的 探讨血清新喋呤、血管内皮生长因子B(vascular endothelial growth factor B,VEGF-B)与新诊断2型糖尿病(type 2 diabetes mellitus,T2DM)患者周围神经病变的相关性。方法 选取2018年6月-2020年5月衡水哈励逊国际和平医院住院治疗的103例新诊断T2DM患者,根据有无糖尿病周围神经病变(diabetic peripheral neurophathy,DPN)分为DPN组(38例)和非DPN组(65例)。应用美国Bio-Tek ELX800多功能酶标仪检测血清新喋呤和VEGF-B水平。绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)并计算曲线下面积(area under the curve,AUC)分析血清新喋呤、VEGF-B对新诊断2型糖尿病患者周围神经病变的预测价值,多因素logistic回归分析探讨新诊断2型糖尿病患者周围神经病变的相关因素。结果 DPN组患者甘油三酯(Triglyceride,TG)水平低于非DPN组,糖化血红蛋白(glycated hemoglobin,HbAlc)、空腹血糖(fasting blood glucose,FPG)水平高于非DPN组(均P<0.05)。DPN组血清新喋呤、VEGF-B水平明显高于非DPN组(P<0.05)。新喋呤、VEGF-B与TG呈负相关(r=-0.461、-0.478,均P<0.05)。新喋呤、VEGF-B与HbAlc、FPG呈正相关(r=0.541、0.502、0.627、0.593,均P<0.05)。血清新喋呤、VEGF-B预测发生DPN的ROC曲线下面积(AUC)分别为0.803(95%CI:0.727-0.874)、0.789(95%CI:0.711-0.858)。在23.5nmol/L的临界值下,新喋呤预测的灵敏度为80.5%,特异度为83.3%;在170.0pg/ml的临界值下,VEGF-B预测的灵敏度为69.4%,特异度为86.8%。新喋呤和VEGF-B联合预测灵敏度为89.6%,特异度为80.1%。多因素logistics回归分析显示,新喋呤≥23.5nmol/L、VEGF-B≥170.0pg/ml是T2DM患者发生DPN独立危险因素,其OR及95%CI分别为1.618(1.126-2.325)、1.441(1.154-1.797)(均P<0.05)。结论 新诊断2型糖尿病并发周围神经病变患者血清新蝶呤、VEGF-B升高,新蝶呤、VEGF-B是新诊断2型糖尿病患者发生周围神经病变的独立预测因素,二者有望作为新诊断2型糖尿病并发周围神经�Objective To investigate the association between serum neopterin, vascular endothelial growth factor B(VEGF-B) and peripheral neuropathy in in newly diagnosed patients with type 2 diabetes mellitus(T2DM). Methods A total of 103 newly diagnosed T2DM patients who were hospitalized in Hengshui Harixun International Peace Hospital from June 2018 to May 2020 were selected and divided into DPN group(38 cases) and non-DPN group(65 cases) according to the presence or absence of diabetic peripheral neuropathy(DPN). The levels of serum neopterin and VEGF-B was detected by U.S. Bio-Tek ELX800 multifunctional microplate reader. The receiver operating characteristic curve(ROC) and the area under the curve(AUC) was used to evaluate the performance of serum neopterin and VEGF-B in prediction of peripheral neuropathy in newly diagnosed patients with T2DM. And multivariate logistic regression was used to explore related factors of peripheral neuropathy in newly diagnosed patients with T2DM. Results The levels of triglyceride(TG) in the DPN group were lower than that in the non-DPN group, and the levels of glycated hemoglobin(HbAlc) and fasting blood glucose(FPG) were higher than these in the non-DPN group(P<0.05). The levels of serum neopterin and VEGF-B in the DPN group were significantly higher than those in the non-DPN group(P<0.05). Neopterin, VEGF-B were negatively correlated with TG(r=-0.461,-0.478, P<0.05). Neopterin, VEGF-B were positively correlated with HbAlc and FPG(r=0.541, 0.502, 0.627, 0.593, P<0.05). The area under the ROC curve(AUC) of serum neopterin and VEGF-B predicting DPN were 0.803(95%CI: 0.727~0.874) and 0.789(95%CI: 0.711~0.858) respectively.Under the cut-off value of 23.5nmol/L, the prediction sensitivity of neopterin was 80.5% and the specificity was 80.3%.Under the cut-off value of 170.0pg/ml, the prediction sensitivity of VEGF-B was 69.4% and the specificity was 86.8%.The combined prediction sensitivity of neopterin and VEGF-B was 89.6%, and the specificity was 80.1%. The results of multivariate logist

关 键 词：新喋呤 血管内皮生长因子B 2型糖尿病 周围神经病变 

分 类 号：R587.1[医药卫生—内分泌]