摘要
目的探讨老年2型糖尿病(T2DM)患者血清胱抑素C(CysC)与震动感觉阈值(VPT)的关系。方法回顾性分析2021年1月—2022年12月于复旦大学附属上海市第五人民医院诊治的587例老年T2DM患者临床资料。根据VPT评估结果分为糖尿病组(n=221)、减退组(n=217)和缺失组(n=149)。记录受试者入院时的年龄、T2DM病程、体质量指数、收缩压、舒张压、糖化血红蛋白(HbA1c)、三酰甘油、低密度脂蛋白胆固醇、谷丙转氨酶、血尿酸、血肌酐(SCr)、血尿素氮、估算肾小球滤过率(eGFR)和CysC。分析血清CysC及相关指标与VPT的相关性,探讨VPT的危险因素。结果与糖尿病组比较,减退组年龄较大(P<0.01);缺失组年龄较大,病程较长,HbA1c、SCr、CysC较高,eGFR较低,差异均有统计学意义(P<0.05)。与减退组比较,缺失组SCr、CysC较高,eGFR较低,差异均有统计学意义(P<0.05)。3组间年龄、病程、HbA1c、CysC、SCr和eGFR差异有统计学意义(P<0.05)。Spearman相关性分析显示,年龄、T2DM病程、HbA1c、SCr以及CysC与VPT呈正相关(P<0.05),eGFR与VPT呈负相关(P<0.01)。逐步回归分析结果显示,年龄、T2DM病程、HbA1c以及CysC是VPT的独立危险因素(P<0.05)。结论血清CysC升高可能是T2DM远端对称性多发性神经病变的潜在危险因素。
Objective To investigate the relationship between serum cystatin C(CysC)and vibration perception threshold(VPT)in elderly patients with type 2 diabetes mellitus(T2DM).Methods The clinical data of 587 elderly T2DM patients diagnosed and treated in Shanghai Fifth People s Hospital,Fudan University from January 2021 to December 2022 were retrospectively analyzed.They were divided into diabetic group(n=221),reduction group(n=217)and deficient group(n=149)according to the results of VPT evaluation.Their age,T2DM course,body mass index,systolic blood pressure,diastolic blood pressure,glycosylated hemoglobin(HbA1c),triglyceride,low density lipoprotein cholesterol,alanine aminotransferase,serum uric acid,serum creatinine(SCr),blood urea nitrogen,estimated glomerular filtration rate(eGFR),and CysC at admission were recorded.The correlation between serum CysC and other related indexes and VPT was analyzed to explore the risk factors of VPT.Results Compared with the diabetes group,the reduction group was older(P<0.01);the deficient group had older age,longer disease duration,higher levels of HbA1c,SCr,and CysC,and lower eGFR level,with statistically significant differences(P<0.05).Compared with the reduction group,the deficient group had higher levels of SCr and CysC,and lower eGFR level,and the differences were statistically significant(P<0.05).There were statistically significant differences in age,disease duration and levels of HbA1c,CysC,SCr and eGFR among the three groups(P<0.05).Spearman correlation analysis showed that disease duration,age,HbA1c,CysC,and SCr were positively correlated with VPT(P<0.05),while eGFR was negatively correlated with VPT(P<0.01).Multiple stepwise regression analysis showed that age,disease duration,HbA1c and CysC were the risk factors of VPT(P<0.05).Conclusion Elevated serum CysC may be a potential risk factor for distal symmetric polyneuropathy in T2DM patients.
作者
李文晓
谌衍
查兵兵
丁和远
Li Wenxiao;Chen Yan;Zha Bingbing;Ding Heyuan(Department of Endocrinology,Shanghai Fifth People s Hospital,Fudan University,Shanghai,200240,P.R.China;Health Service Center of Jiangchuan Community,Shanghai,200240,P.R.China;Community Health Research Center(Preparation)of Fudan University,Shanghai,200240,P.R.China)
出处
《老年医学与保健》
CAS
2023年第3期561-564,共4页
Geriatrics & Health Care
基金
复旦-闵行健康联合体合作项目(2022FM01)
复旦大学社区健康研究中心(筹)社区健康科研项目(2020SJ06)。
关键词
老年
2型糖尿病
胱抑素C
震动感觉阈值
elderly
type 2 diabetes mellitus
cystatin C
vibration perception threshold
