摘要
目的:探讨血清25羟维生素D[25(OH)D]、胱抑素C(CysC)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与2型糖尿病(T2DM)合并桥本甲状腺炎(HT)患者发生糖尿病周围神经病变(DPN)的关系。方法:选取2020年1月~2023年1月合肥市第二人民医院内分泌科收治的T2DM合并HT患者150例为T2DM合并HT组,另选取同期150例单纯T2DM患者纳入单纯T2DM组,根据是否发生DNP将T2DM合并HT患者分为DNP组93例和非DNP组57例。检测和计算血清25(OH)D、CysC、NLR、PLR,采用多因素Logistic回归分析T2DM合并HT患者发生DNP的影响因素,采用受试者工作特征(ROC)曲线分析血清25(OH)D、CysC、NLR、PLR对T2DM合并HT患者发生DNP的预测价值。结果:与单纯T2DM组比较,T2DM合并HT组的血清25(OH)D水平降低,血清CysC、NLR、PLR升高,差异有统计学意义(P<0.05)。150例T2DM合并HT患者DNP发生率为62.00%(93/150)。多因素Logistic回归分析显示,T2DM病程延长和糖化血红蛋白(HbA1c)、促甲状腺激素(TSH)、CysC、NLR、PLR升高为影响T2DM合并HT患者发生DNP的独立危险因素,25(OH)D升高为独立保护因素(P<0.05)。ROC曲线分析显示,血清25(OH)D、CysC、NLR、PLR联合预测T2DM合并HT患者发生DNP的曲线下面积为0.920,大于血清25(OH)D、CysC、NLR、PLR单独预测。结论:T2DM合并HT患者血清25(OH)D水平降低,CysC、NLR、PLR升高,是T2DM合并HT患者发生DNP的独立影响因素,血清25(OH)D、CysC、NLR、PLR联合预测T2DM合并HT患者发生DNP的价值较高。
Objective:To investigate the relationship between serum 25-hydroxyvitamin D[25(OH)D],cystatin C(CysC),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and diabetic peripheral neuropathy(DPN)in patients with type 2 diabetes mellitus(T2DM)combine with Hashimoto's thyroiditis(HT).Methods:150 patients with T2DM combine with HT who were admitted to the Endocrinology Department of Hefei Second People's Hospital from January 2020 to January 2023 were selected as T2DM combine with HT group,and 150 patients with simple T2DM during the same period were selected as simple T2DM group,patients with T2DM combine with HT were divided into DNP group(n=93)and non-DNP group(n=57)according to whether DNP occurred.Serum 25(OH)D,CysC,NLR and PLR were detected and calculated,the influencing factors of DNP in patients with T2DM combine with HT were analyzed by multivariate logistic regression,the predictive value of serum 25(OH)D,CysC,NLR and PLR for DNP in patients with T2DM combine with HT were analyzed by receiver operating characteristic(ROC)curve.Results:Compared with simple T2DM group,the serum 25(OH)D level decreased and serum CysC,NLR and PLR increased in T2DM combined with HT group,and the difference was statistically significant(P<0.05).The incidence of DNP in 150 patients with T2DM combine with HT was 62.00%(93/150).Multivariate logistic regression analysis showed that,prolonged course of T2DM and elevated levels of glycosylated hemoglobin(HbAlc),thyroid stimulating hormone(TSH),CysC,NLR and PLR were independent risk factors for DNP in patients with T2DM combine with HT,and elevated level of 25(OH)D was an independent protective factor(P<0.05).ROC curve analysis showed that,the area under the curve of serum 25(OH)D,CysC,NLR and PLR combined to predict DNP in patients with T2DM combine with HT was 0.920,which was greater than that of serum 25(OH)D,CysC,NLR and PLR alone.Conclusion:The decrease of serum 25(OH)D level and the increase of CysC,NLR and PLR in patients with T2DM combine with HT,which are independent influencing factors of DNP in patients with T2DM combine with HT,the combination of serum 25(OH)D,CysC,NLR and PLR has a high predictive value for DNP in patients with T2DM combine with HT.
作者
石珍珍
尹德超
朱小欢
胡婷
宋佳佳
SHI Zhen-zhen;YIN De-chao;ZHU Xiao-huan;HU Ting;SONG Jia-jia(Department of Endocrinology,Hefei Second People's Hospital,Hefei,Anhui,230011,China)
出处
《现代生物医学进展》
CAS
2024年第7期1369-1374,共6页
Progress in Modern Biomedicine
基金
安徽省科技攻关计划项目(1604a0802099)。
