| Objective:To study the relation between free fatty acid, C-reactive proteinã€homocysteine and peripheral neuropathy of type 2 diabetes.Methods:404 patients diagnosed with type 2 diabetes in Sir Run Run Shaw Hospital from January 1,2014 to June 30,2015 were selected. Divide them into two groups, namely 235 cases in non-diabetic peripheral neuropathy (NDPN) group and 169 patients in diabetic peripheral neurapathy (DPN) group. DPN group was further divided into subclinical diabetic peripheral neuropathy (80 cases, SDPN) group and clinical diabetic peripheral neuropathy (89 cases, CDPN) group according to the standard of 19th Annual Meeting of Diabetic Neuropathy Research Group of the European Association for the Study of Diabetes 2009 in Toronto.The general information of every patient is recorded as follows:age, sex, diabetic duration, diabetic family history, hypertension history, smoking history, alcohol intake, drugs, peripheral neuropathy symptoms, height, weight, waistline and blood pressure. Besides, record the level of HbAlc, liver function, renal function, total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), uric acid, cystatin C, Hey, FFA, CRP, thyroid function,24 hours urine micro albumin(MA), albumin/creatinine(ACR), fasting blood-glucose(FBG)by standardized steamed bread meal test (the same as below), 2-hour postprandial blood glucose (2hPG), fasting insulin(FINS),2-hour postprandial insulin(INS2h), fasting plasma c-peptide (FCP),2-hour postprandial c-peptide (CPC). Calculation of ankle brachial index (ABI), fundus photography, electromyography and so on were performed in each patient, so was B ultrasound examination of abdomen, lower limb artery and carotid artery. Use SPSS software version 18.0 to compare each parameter between NDPN and DPN, SDPN and NDPN, CDPN and NDPN, CDPN and SDPN. Use kolmogorov-smirnov test and homogeneity test of variance for all data. Perform x2 test for count date, t test for normally distributed data, Mann-Whitney U test for non-normally distributed data. Analyze the risk factors of diabetic peripheral neuropathy in type 2 diabetes by multiple logistic regression analysis.Results:1. In NDPN, SDPN and CDPN, age, systolic pressure, rate of diabetic nephropathy are higher in SDPN and CDPN than in NDPN(P<0.05), islet cell function(HOMA-β(CP)), eGFR are lower in SDPN and CDPN than in NDPN(P<0.05); rate of hypertion history, levels of FBG, PG2h are higher in SDPN than in NDPN(P<0.05), whereas, BMI is lower in SDPN than in NDPN(P<0.05); diabetic duration, diabetic family history, level of Cys-C, ACR and rate of rate of diabetic retinopathy are are higher in CDPN than in NDPN(P<0.05), whereas, FCP and rate of fatty liver are lower in CDPN than in NDPN(P<0.05); rate of diabetic retinopathy is higher in CDPN than in SDPN.2. Level of Hcy is higher in DPN, SDPN, CDPN than in NDPN. FFA and CRP have no significance in three groups.3. Age(OR=1.054,95% CI=1.011-1.099,P=0.014) and Hcy(OR=1.099,95% CI=1.012-1.192, P=0.024)are independent risk factors in type 2 diabetes according to Logistic multivariate regression analysis. Diabetic retinopathy and diabetic nephropathy are sociated with diabetic peripheral neuropathy.Conclusion:(1)Hcy and age are independent risk factors in type 2 diabetes. Hcy becomes high in subclincal peripheral neuropathy. Detecting Hcy and early intervention may check the progress of diabetic peripheral neuropathy.(2) Diabetic retinopathy and diabetic nephropathy are sociated with diabetic peripheral neuropathy. Diabetic nephropathy probably is related with severity of diabetes peripheral neuropathy.(3)FFA and CRP have no significance with diabetic peripheral neuropathy. |
