糖化血红蛋白与血脂异常对糖尿病患者周围神经病变交互作用的研究  

Interaction between glycosylated hemoglobin and dyslipidemia on peripheral neuropathy in patients with diabetes mellitus

作　　者：郭玲 华飞[1] 刘婷[2] GUO Ling;HUA Fei;LIU Ting(Department of Endocrinology,The Third Affiliated Hospital of Soochow University,Changzhou 213000,China)

机构地区：[1]苏州大学附属第三医院内分泌科,常州213000 [2]上海交通大学附属儿童医学中心分子遗传诊断联合实验室

出　　处：《中国糖尿病杂志》2024年第8期595-600,共6页Chinese Journal of Diabetes

摘　　要：目的探讨高HbA_(1)c与血脂异常对糖尿病周围神经病变(DPN)的交互作用。方法选取2020年7月至2021年7月于苏州大学附属第三医院内分泌科门诊及住院治疗的DPN患者110例为(DPN组),另选取同期本院治疗的T2DM患者110例(T2DM组)。比较两组一般资料和生化指标。LASSO回归和Logistic回归分析DPN的影响因素,并通过相加交互模型分析高HbA_(1)c、血脂异常对DPN的交互作用,受试者工作特征(ROC)曲线分析高HbA_(1)c、血脂异常及二者交互作用对DPN的诊断价值。结果DPN组年龄、吸烟史比例、SBP、WC、TG、HbA_(1)c高于T2DM组(P<0.05)。LASSO和Logistic回归分析显示,年龄、吸烟史、SBP、WC、TG、HDL-C、HbA_(1)c是T2DM患者并发DPN的影响因素。定性及定量分析结果显示,高HbA_(1)c与血脂异常在T2DM患者DPN发病风险中存在交互作用。ROC曲线分析显示,高HbA_(1)c、血脂异常二者协同交互作用对DPN的诊断价值高于单独对DPN的诊断价值。结论TG、HDL-C、HbA_(1)c是T2DM患者合并DPN的影响因素,且存在协同交互作用,高HbA_(1)c与血脂异常增加T2DM患者发生DPN的风险。Objective To investigate the interaction between HbA_(1)c level and dyslipidemia on diabetic peripheral neuropathy(DPN).Methods A total of 110 patients with DPN who were hospitalized in the Department of Endocrinology of the Third Affiliated Hospital of Soochow University were selected as the DPN group,and 110 patients with T2DM who were treated in the Third Affiliated Hospital of Soochow University during the same period were selected as the T2DM group from July 2020 to July 2021.LASSO regression and Logistic regression analysis were used to evaluate the influencing factors for T2DM patients complicated with DPN.The interaction of high HbA_(1)c and dyslipidemia on DPN was analyzed by additive interaction model,and the diagnostic value of high HbA_(1)c,dyslipidemia and their interaction on DPN was analyzed by ROC curve.Results The age,smoking history,SBP,WC,TG and HbA_(1)c were higher in DPN group than in T2DM group(P<0.05).LASSO and logistic regression analysis showed that age,smoking history,SBP,WC,TG,HDL-C and HbA_(1)c were the influencing factors for DPN in T2DM patients.The results of qualitative and quantitative analysis showed that there was an interaction between high HbA_(1)c and dyslipidemia in DPN risk in patients with T2DM.ROC curve analysis showed that the diagnostic value of high HbA_(1)c and dyslipidemia combination was higher in DPN diagnosis than each parameter alone.Conclusions TG,HDL-C and HbA_(1)c are the influencing factors for DPN in T2DM patients,and there is a synergistic interaction.High HbA_(1)c and dyslipidemia increase the risk of DPN in T2DM patients.

关 键 词：糖尿病周围神经病变 糖化血红蛋白 血脂 交互作用 

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