血清MIP-1α与痛性糖尿病周围神经病变的相关性研究  

Correlation between serum MIP-1α and painful diabetic peripheral neuropathy

作　　者：马学芹 刘翠明(指导) 唐正和[1] 吴融花 董丽华 魏娟 MA Xueqin;LIU Cuiming;TANG Zhenghe;WU Ronghua;DONG Lihua;WEI Juan(Department of Endocrinology,Laigang Hospital Affiliated to Shandong First Medical University,Jinan 271104,China)

机构地区：[1]山东第一医科大学附属莱钢医院内分泌科,济南271104

出　　处：《中国免疫学杂志》2022年第19期2395-2399,共5页Chinese Journal of Immunology

基　　金：济南市卫生健康委员会科技计划项目(2021-2-60,2022-2-95)。

摘　　要：目的:探讨血清MIP-1α(巨噬细胞炎症蛋白-1α)在痛性糖尿病周围神经病变(pDPN)患者中的表达水平及临床意义。方法:选取2019年1月至2021年3月于山东第一医科大学附属莱钢医院内分泌科住院2型糖尿病患者260例,根据是否合并糖尿病周围神经病变(DPN)及患者的疼痛评分分为单纯T2DM组(T2DM,n=69)、非pDPN组(非pDPN,n=96)和pDPN组(pDPN,n=95)。选取同期健康体检者为正常对照组(NC,n=62)。测定血清MIP-1α、TNF-α、hs-CRP、IL-10水平。pDPN根据VAS疼痛评分再进行亚分组,检测上述指标。结果:NC、T2DM、非pDPN、pDPN组血清MIP-1α、TNF-α、hs-CRP水平依次升高,IL-10水平依次降低(P<0.05);Pearson相关分析发现,血清MIP-1α水平与糖尿病病程、WHR、FPG、TG、HOMA-IR、hs-CRP、HbA1c、VAS评分呈正相关(P<0.05),与IL-10、TIR、mNCV、sNCV呈负相关(P<0.01)。多因素Logistic回归分析显示:糖尿病病程长,TIR时间少,高FPG、HbA1c和HOMA-IR,高MIP-1α、TNF-α、hs-CRP水平是pDPN的危险因素,进行校正后,其中MIP-1α、TNF-α是影响pDPN发生的独立危险因素。pDPN亚分组后发现,疼痛评分越高,亚组血清MIP-1α、TNF-α、hs-CRP、HAMD-24评分越高,mNCV、sNCV越低(P<0.01)。结论:血清MIP-1α参与炎症免疫反应,是pDPN发生的独立危险因素,与pDPN病情进展密切相关。Objective:To investigate the expression level and clinical significance of serum MIP-1αin patients with painful diabetic peripheral neuropathy(pDPN).Methods:From January 2019 to March 2021,260 patients with type 2 diabetes mellitus who were hospitalized in Department of Endocrinology of Laigang Hospital Affiliated to Shandong First Medical University were divided into simple T2DM group(T2DM,n=69),non-pDPN group(non-pDPN,n=96)and pDPN group(pDPN,n=95)according to whether the diabetic peripheral neuropathy and the pain score of patients were combined.Healthy people in the same period were selected as normal control group(NC,n=62).Serum levels of MIP-1α,TNF-α,hs-CRP and IL-10 were measured.pDPN was divided into subgroups according to VAS pain score.The above indexes were measured.Results:The serum levels of MIP-1α,TNF-αand hs-CRP in NC,T2DM,non pDPN and pDPN groups increased in turn,while IL-10 level was decreased in turn(P<0.05);Pearson correlation analysis showed that serum MIP-1αlevel was positively correlated with the duration of diabetes,WHR,FPG,TG,HOMA-IR,hs-CRP,HbA1c and VAS score(P<0.05),and was negatively correlated with IL-10,TIR,mNCV and sNCV(P<0.01).Multivariate Logistic regression analysis showed that the long duration of diabetes,low TIR time,high FPG,HbA1c and HOMA-IR,high MIP-1α,TNF-αand hs-CRP levels were risk factors of pDPN.After correction,MIP-1αand TNF-αwere independent risk factors for the occurrence of pDPN.After pDPN subgroup,the higher the pain score,the higher the serum MIP-1α、the higher the scores of TNF-α,hs-CRP and HAMD-24,the lower the mNCV and sNCV(P<0.01).Conclusion:Serum MIP-1αis involved in inflammatory immune response,which is an independent risk factor for pDPN and closely related to the progression of pDPN.

关 键 词：巨噬细胞炎症蛋白-1Α 糖尿病周围神经病变 痛性 炎症免疫反应 葡萄糖目标范围内时间 

分 类 号：R587.1[医药卫生—内分泌]