基于倾向性评分匹配探讨尿游离皮质醇预测2型糖尿病并发周围神经病变的价值  

The Value of Urinary Free Cortisol in Predicting Type 2 Diabetes Mellitus Complicated with Diabetic Peripheral Neuropathy Based on Propensity Scoring Matching Method

作　　者：靖鑫烨 翟娜 司劲涛 谢幸 薛艳艳 王翯[2] JING Xinye;ZHAI Na;SI Jintao;XIE Xing;XUE Yanyan;WANG He(Endocrine Laboratory,Baoding First Central Hospital,Baoding 071000,China;Department 1 of Endocrinology,Baoding First Central Hospital,Baoding 071000,China)

机构地区：[1]保定市第一中心医院内分泌实验室,河北保定071000 [2]保定市第一中心医院内分泌一科,河北保定071000

出　　处：《标记免疫分析与临床》2024年第12期2299-2303,2341,共6页Labeled Immunoassays and Clinical Medicine

基　　金：保定市科技计划项目(编号:2441ZF041)。

摘　　要：目的基于倾向性评分匹配(propensity scoring matching,PSM)分析尿游离皮质醇(urinary free cortisol,UFC)预测2型糖尿病(type 2 diabetes mellitus,T2DM)并发周围神经病变(diabetic peripheral neuropathy,DPN)的价值。方法回顾性分析2018年6月至2024年6月于我院进行治疗的345例T2MD患者的临床资料,根据是否发生DPN分为DPN组(156例),单纯T2MD组(189例),采用PSM对两组患者的一般资料进行匹配。通过单因素、多因素Logistic回归分析法明确影响T2MD患者并发DPN的危险因素;受试者工作曲线(receiver operating characteristic curve,ROC)评估UFC预测T2MD患者并发DPN的价值。结果PSM后共成功匹配137组患者,PSM前两组患者在年龄、BMI、吸烟史方面的差异具有统计学意义(P<0.05),PSM后两组患者的一般资料方面差异无统计学意义(P>0.05)。单因素分析显示两组患者在糖尿病病程、HbA1c水平、UFC水平差异有统计学意义(P<0.05),LDL-C、HDL-C、TC、TG、Scr、SUA、ALT、AST水平方面差异无统计学意义(P>0.05);Logistic多因素回归分析显示,HbA1c水平高(OR=14.08,95%CI 5.98~33.11)、糖尿病病程长(OR=1.58,95%CI 1.19~2.10)、UFC水平升高(OR=1.12,95%CI 1.06~1.17)是影响T2MD患者并发DPN的危险因素。ROC曲线分析显示T2MD患者UFC水平预测发生DPN的灵敏度、特异性、AUC分别为84.67%、66.42%、0.810。结论T2MD患者的UFC水平与其并发DPN密切相关,且UFC水平升高可能是预测T2MD患者并发DPN的有效预测因子。Objective To investigate the value of urinary free cortisol(UFC) in predicting type 2 diabetes mellitus(T2DM) complicated with diabetic peripheral neuropathy(DPN) based on propensity scoring matching(PSM) method.Methods A retrospective analysis was conducted on the clinical data of 345 patients with T2DM treated in our hospital from June,2018 to June,2024.Patients were divided into the DPN group(156 cases) and the simple T2DM group(189 cases) based on the presence of DPN.PSM method was applied to match the general information of patients between the two groups.Univariate and multivariate logistic regression analyses were performed to identify risk factors for DPN in T2DM patients.The receiver operating characteristic curve(ROC) was drawn to evaluate the value of UFC in predicting DPN in T2DM patients.Results Through PSM process,a total of 137 pairs of patients were successfully matched.Before PSM,there were statistically significant differences in age,BMI,and smoking history between the two groups(P<0.05),while after PSM,there were no significant differences in general information between the two groups(P>0.05).Univariate analysis showed significant differences in diabetes duration,HbA1c level,and UFC level between the two groups(P<0.05),but no significant differences in LDL-C,HDL-C,TC,TG,Scr,SUA,ALT,and AST levels(P>0.05).Multivariate logistic regression analysis revealed that high HbA1c level(OR=14.08,95% CI 5.98~33.11),long diabetes duration(OR=1.58,95% CI 1.19~2.10),and elevated UFC level(OR=1.12,95% CI 1.06~1.17) were risk factors for DPN in T2DM patients.ROC curve showed that the sensitivity,specificity,and AUC of UFC level in predicting DPN in T2DM patients were 84.67%,66.42%,and 0.810,respectively.Conclusion UFC level of T2DM patients is closely related to the development of DPN,and elevated UFC level could serve as an effective predictor for DPN in T2DM patients.

关 键 词：倾向性评分匹配 尿游离皮质醇 糖尿病 周围神经病变 

分 类 号：R587.2[医药卫生—内分泌]