痛性糖尿病周围神经病变患者血清Metrnl水平变化的研究  

Changes of serum Metrnl level in patients with painful diabetic peripheral neuropathy

作　　者：刘翠明 李翠翠 马学芹 唐正和[1] LIU Cuiming;LI Cuicui;MA Xueqin(Department of Endocrinology,Laigang Hospital Affiliated to Shandong First Medical University,Jinan 271126,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271126 [2]济南市人民医院干部保健科

出　　处：《中国糖尿病杂志》2023年第5期325-329,共5页Chinese Journal of Diabetes

基　　金：济南市卫生健康委员会科技计划项目(2022-2-94)。

摘　　要：目的探讨痛性糖尿病周围神经病变(PDPN)患者血清Metrnl水平的变化。方法选取2020年10月至2021年9月于山东第一医科大学附属莱钢医院内分泌科住院治疗的T2DM患者180例,分为单纯糖尿病组(n=54)、非PDPN组(non-PDPN,n=56)及PDPN组(n=70)。PDPN组根据视觉模拟评分法(VAS)分为轻度疼痛亚组22例、中度疼痛亚组25例及重度疼痛亚组23例。同期选取我院体检健康者50名为正常对照(NC)组。比较各组及各亚组一般资料及血清Metrnl水平。结果NC、T2DM、non-PDPN、PDPN组血清Metrnl依次降低(P<0.05)。PDPN各亚组中,VAS评分越高,血清Metrnl越低(P<0.05)。Spearman相关分析显示,血清Metrnl与胫神经运动神经传导速度、腓总神经感觉神经传导速度及超氧化物歧化酶(SOD)呈正相关(P<0.05),与DM病程、TG、胰岛素抵抗指数、HbA1c、VPT、TNF-α、IL-6、丙二醛及VAS评分呈负相关(P<0.05)。Logistic回归分析显示,校正DM病程、HbA1c后,低水平SOD、Metrnl是PDPN的危险因素。结论PDPN患者血清Metrnl降低,随着VAS评分升高而降低,血清Metrnl可能参与PDPN的发生发展。Objective To investigate the changes of serum Metrnl level in painful diabetic peripheral neuropathy(PDPN).N Methods 180 type 2 diabetes mellitus(T2DM)patients hospitalized in Laigang Hospital Affiliated to Shandong First Medical University from October 2020 to September 2021 were selected and divided into simple T2DM group(n=54),non-painful diabetic peripheral neuropathy group(non-PDPN,n=56)and painful diabetic peripheral neuropathy group(PDPN,n=70).The patients in PDPN group was divided into three subgroup(22 with mild pain,25 with moderate pain and 23 with severe pain)according to the visual analogue scale(VAS).50 healthy subjects in the same period were selected as the normal control group(NC group).Serum Metrnl levels were measured and compared among dfferent groups.Results The level of serum Metrnl sequentially decreased from NC group,T2DM group,non-PDPN group to PDPN group in turn(P<0.05).In PDPN subgroup,the higher the VAS score,the lower the Metnl level(P<0.05).Spearman correlation analysis showed that serum Metrnl level was positively correlated with tibial nerve motor nerve conduction velocity,common peroneal nerve sensory nerve conduction velocity and superoxide dismutase(SOD)(P<O.05),and negatively correlated with diabetes duration,TG,HOMA-IR,HbAic,vibration perception thresholds(VPT),TNF-α,IL-6,malondialdehyde and VAS scores(P<0.05).Logistic regression analysis showed that low levels of SOD and Metrnl were independent risk factors for PDPN after adjusting for diabetes duration and HbAic.Conclusion Serum Metrnl in patients with PDPN is lecreased and correlated with VAS score,which may be involved in the occurrence and development of PDPN.

关 键 词：Metrnl 痛性糖尿病周围神经病变 氧化应激 炎症反应 

分 类 号：R587.2[医药卫生—内分泌] R747.9[医药卫生—内科学]