| Research BackgroundThe number of diabetes in China ranks first in the world.Diabetes peripheral neuropathy(DPN)is a common chronic complication of diabetes,and distal symmetric polyneuropathy(DSPN)is the most common in DPN.If DSPN develops to a certain stage and is not recognized,it is very easy to cause foot injury due to nerve damage,which will lead to vascular dysfunction in the lower limbs,and ultimately lead to infection,sepsis,and amputation due to trauma.At present,the pathogenesis of DSPN is not completely clear;After strictly controlling the currently known risk factors,DSPN is still making progress,and the progress mechanism is still unclear;Some studies have shown that hyperuricemia(HUA)can promote the occurrence of chronic complications of diabetes to a certain extent.This study intends to find relevant risk factors affecting the occurrence and development of DSPN by analyzing the correlation between DSPN and blood uric acid,so as to provide a basis for early intervention and prevention of DSPN.ObjectiveBinary multivariate Logistics regression and tendency score matching(PSM)were used to explore the correlation between serum uric acid level and DSPN in patients with T2DM,explore the related risk factors of DSPN,and use ROC curve to explore the prediction mechanism of serum uric acid on DSPN,so as to provide new ideas for the diagnosis and treatment of diabetic peripheral neuropathy.MethodsA total of 529 inpatients in the department of endocrinology of our hospital from December 2018 to August 2020 were selected to collect relevant data,compare the biochemical indicators between the two groups,and analyze the correlation between DSPN and serum uric acid.According to the level of serum uric acid,a quartile grouping was carried out,and PSM was used to balance the covariates of each group,and multivariate logistic regression was used to explore and analyze the correlation between serum uric acid and DSPN before and after PSM,At the same time,the ROC curve is used to find the risk factors that can be used to predict the onset of DSPN.Results1.A total of 529 patients with an average age of(53.13 ±12.80)years were included.The basic data of the two groups were analyzed according to whether DSPN was available or not.The results showed that there were statistically significant differences in age,hypertension,DR,uric acid,LDL-C,apolipoprotein B,macrovascular complications,and the course of DM between the two groups(P<0.05).There was no significant difference between sex,smoking,drinking,BMI,TC,TG,HDL-C,HbA1c and fatty liver(P>0.05);2.Multivariate logistic regression analysis was performed with serum uric acid as the independent variable.The results showed that the average value of serum uric acid in DSPN group was higher than that in NDSPN group.Taking 300,353,416umol/L as the cutoff point and q1 as the reference,the uric acid was divided into four groups for multifactor logistic regression analysis.The results showed that the risk of DSPN in q2,q3,and q4 groups was 1.022,1.107,and 23.051 times higher than that in q1 group,respectively.The difference between q4 groups was statistically significant(P<0.001).3.In order to balance the differences of other variables between the two groups,PSM was used to analyze again.The results showed that 111 patients with DSPN and NDSPN were matched,and there was no statistical difference between the two groups in other covariates except uric acid.The analysis of uric acid and DSPN by independent sample T test showed that the blood uric acid level between the two groups was statistically significant.After PSM,uric acid was divided into quartiles,with q1 as the reference group,and uric acid was analyzed with 273,326,409 umol/L as the cutoff point.The results showed that the risk of DSPN in blood uric acid Q2,Q3,and Q4 groups was 2.252,2.897,and 22.615 times higher than that in q1 group,respectively,and the difference between Q3 and Q4 groups was statistically significant.4.Using DSPN as the dependent variable for ROC analysis,it was found that the area under the ROC curve of age,duration of DM,DR,macrovascular complications,and uric acid was statistically significant(P<0.05).When DR,macrovascular complications,age was more than 57.5 years,blood uric acid was higher than 393.75 umol/L,and the duration of DM was more than 5.5 years,it could be used as a condition for predicting DSPN.Conclusion(1)There was a positive correlation between serum uric acid and distal symmetric polyneuropathy in type 2 diabetes.(2)In binary logistic regression,it was found that the higher uric acid,the higher the risk of developing DSPN.The risk of developing DSPN when uric acid>416umol/L is 3.051 times higher than when uric acid≤300umol/L.(3)After propensity score matching between the two groups,it was found that when the blood uric acid levels were 326-409 umol/L and>409 umol/L,the risk of developing DSPN was 2.90 and 22.615 times higher than when the blood uric acid levels were<273 umol/L.(4)DR,macrovascular complications,age greater than 57.5 years,and blood uric acid>393.75 umol/L may be risk factors for predicting the onset of DSPN. |
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