LMR、IGFBP-3对2型糖尿病周围神经病的预测价值  

Predictive value of LMR and IGFBP-3 in peripheral neuropathy in type 2 di-abetes mellitus

作　　者：卢宁 仇颖 边德志 刘艳梅[1] LU Ning;QIU Ying;BIAN De-zhi;LIU Yan-mei(Department of Endocrinology,Yancheng Clinical College of Medicine,Jiangsu University/Yancheng First People's Hospital,Yancheng 224000,China)

机构地区：[1]江苏大学盐城临床医学院,盐城市第一人民医院内分泌科,江苏盐城224000

出　　处：《哈尔滨医科大学学报》2024年第6期628-632,共5页Journal of Harbin Medical University

基　　金：江苏省自然科学基金资助项目(BK20211375)。

摘　　要：目的 分析淋巴细胞与单核细胞比值(lymphocyte to monocyte ration, LMR)、胰岛素样生长因子结合蛋白3(insulin-like growth factor binding protein 3,IGFBP-3)对2型糖尿病周围神经病(diabetic peripheral neuropathy, DPN)的预测价值。方法 回顾性分析2021年5月~2023年2月我院收治的151例2型糖尿病患者的临床资料。随访1年,根据患者是否发生DPN分为发生组(n=62)与非发生组(n=89)。比较2组临床资料、LMR、IGFBP-3水平,分析2型糖尿病患者发生DPN的影响因素,分析LMR、IGFBP-3及二者联合对2型糖尿病患者发生DPN的预测价值。结果 随访1年,151例2型糖尿病患者中,DPN发生率为41.06%(62/151)。发生组年龄、糖尿病病程、糖化血红蛋白、空腹血糖(fasting plasma glucose, FPG)水平高于非发生组(P<0.05),发生组血红蛋白水平低于非发生组(P<0.05)。发生组LMR、IGFBP-3水平低于非发生组(P<0.05)。Logistic回归分析结果显示,糖化血红蛋白(OR=4.108,95%CI:1.806~9.345)、糖尿病病程(OR=3.347,95%CI:1.471~7.613)、LMR(OR=0.268,95%CI:0.118~0.611)、IGFBP-3(OR=0.240,95%CI:0.106~0.546)为2型糖尿病患者发生DPN的影响因素(P<0.05)。LMR、IGFBP-3及二者联合预测2型糖尿病患者发生DPN的曲线下面积(area under the curve, AUC)分别为0.799、0.796、0.905(P<0.05),且二者联合的AUC值更高(P<0.05)。结论 LMR、IGFBP-3在预测2型糖尿病患者发生DPN中具有重要价值,且二者联合的预测价值更高。Objective To evaluate the predictive value of lymphocyte to monocyte ratio(LMR)and insulin-like growth factor binding protein 3(IGFBP-3)in type 2 diabetic peripheral neu-ropathy(DPN).Methods The clinical data of 151 patients with type 2 diabetes admitted to our hospital from May 2021 to February 2023 were retrospectively analyzed.The patients were followed up for 1 year and divided into two groups according to whether DPN occurred or not.The clinical data,LMR and IGFBP-3 levels of the two groups were compared,the influencing factors of DPN occurrence in type 2 diabetes patient was analyzed,and the predictive value of LMR,IGFBP-3 and their combination on DPN occurrence in type 2 diabetes patients were ana-lyzed.Results Among 151 patients with type 2 diabetes,the incidence of DPN was 41.06%(62/151).The levels of age,diabetes course,glycated hemoglobin and fasting plasma glucose(FPG)in occurrence group were higher than those in non-occurrence group(P<0.05),and the hemoglobin level in occurrence group was lower than that in non-occurrence group(P<0.05).The levels of LMR and IGFBP-3 in occurrence group were lower than those in non-oc-currence group(P<0.05).Logistic regression analysis showed that glycosylated hemoglobin(OR=4.108,95%CI:1.806-9.345),diabetes duration(OR=3.347,95%CI:1.471~7.613),LMR(OR=0.268,95%CI:0.118-0.611)and IGFBP-3(OR=0.240,95%CI:0.106-0.546)were the influencing factors for DPN in type 2 diabetes patients(P<0.05).The area under the curve(AUC)of LMR,IGFBP-3 and their combination predicted DPN in type 2 diabetes patients were 0.799,0.796 and 0.905,respectively(P<0.05),and the AUC value of the combination was higher(P<0.05).Conclusion LMR and IGFBP-3 have important value in predicting DPN in patients with type 2 diabetes,and their combined value is higher.

关 键 词：淋巴细胞与单核细胞比值 胰岛素样生长因子结合蛋白3 2型糖尿病 糖尿病周围神经病 预测价值 

分 类 号：R587.2[医药卫生—内分泌]