摘要
目的:研究一氧化氮(NO)、晚期糖基化产物(AGEs)监测对无症状2型糖尿病(T2DM)周围神经病变(DPN)的临床意义。方法:选取2015年12月至2018年12月间浙江中医药大学附属第三医院的T2DM住院患者80例,通过测定振动感觉阈值(VPT)联合神经传导速度(NCV)诊断为DPN的患者60例,其余20例为单纯T2DM组。60例DPN患者再通过有无肢体麻木、烧灼感、疼痛等症状分为有症状DPN组29例和无症状DPN组31例。比较3组患者的空腹血糖(FPG)、餐后2 h血糖(PPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)、载脂蛋白a(APOa)、载脂蛋白b(APOb)水平;比较3组患者NO、AGEs水平差异。结果:有症状DPN组的FPG、PPG、HbA1c水平均明显高于无症状DPN及单纯T2DM患者(P<0.01)。无症状DPN组的FPG、PPG、HbA1c水平均高于单纯T2DM患者(P<0.05)。3组患者的TG、TC、LDL-c、HDL-c、APOa、APOb水平差异无统计学意义(P>0.05)。与单纯T2DM组比,DPN组血清NO均明显下降,AGEs水平明显升高(P<0.01);2组DPN患者血清NO、AGEs水平差异有统计学意义(P<0.01)。结论:临床上早期无症状DPN发病率高,NO、AGEs是其重要的生物信号和效应分子,早期检测有助于了解神经病变的程度。控制血糖对减少DPN的发生具有非常重要的临床意义。
Objective:To study the clinical significance of monitoring nitric oxide(NO)and advanced glycation end-products(AGEs)in asymptomatic type 2 diabetes mellitus(T2DM)peripheral neuropathy(DPN).Methods:From December 2015 to December 2018,a total of 80 inpatients with T2DM from the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine were selected.60 patients were diagnosed as DPN by measuring vibration perception threshold(VPT)and nerve conduction velocity(NCV),and the remaining 20 patients were in simple T2DM group.And then 60 DPN patients were further divided into symptomatic DPN group(n=29)and asymptomatic DPN group(n=31)by the presence or absence of limb numbness,burning sensation,pain and other symptoms.The levels of fasting plasma glucose(FPG),2-hour postprandial plasma glucose(PPG),glycosylated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-c),high-density lipoprotein cholesterol(HDL-c),apolipoprotein a(APOa)and apolipoprotein b(APOb)were compared among the three groups,and the results of NO and AGEs were also compared among the three groups.Results:The levels of FPG,PPG and HbA1c in symptomatic DPN group were significantly higher than those in asymptomatic DPN group and simple T2DM group(P<0.01).The levels of FPG,PPG,and HbA1c in asymptomatic DPN group were higher than those in simple T2DM group(P<0.05).There were no significant differences in the levels of TG,TC,LDL-c,HDL-c,APOa and APOb among the three groups(P>0.05).Compared with simple T2DM group,in two DPN groups the levels of serum NO were significantly decreased and the levels of serum AGEs were significantly increased(P<0.01);the levels of serum NO and AGEs were significantly different between the two DPN groups(P<0.01).Conclusion:The incidence of early asymptomatic DPN is high in clinical practice.NO and AGEs are important biological signals and effector molecules.Early detection of them will help to understand the degree of neuropathy.Controlling blood glucose is of great clinical importance in reducing the incidence of DPN.
作者
徐英英
黄兴友
魏智利
王陈芳
留菁菁
潘伟力
XU Yingying;HUANG Xingyou;WEI Zhili;WANG Chenfang;LIU Jingjing;PAN Weili(Department of Endocrinology,Rheumatology and Nephrology,the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310005,China;Inspection Division of the Third Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310005,China;the Third Clinical Medical College of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310014,China)
出处
《温州医科大学学报》
CAS
2020年第5期411-414,418,共5页
Journal of Wenzhou Medical University
基金
浙江省中医药科技计划项目(2015ZB075)。
关键词
糖尿病周围神经病变
一氧化氮
晚期糖基化产物
神经传导速度
振动感觉阈值
diabetic peripheral neuropathy
nitric oxide
advanced glycation end-products
nerve conduction velocity
vibration perception threshold
