Association Between Atherogenic Index Of Plasma And Diabeticperi Pheral Neuropathyinpatients With Type 2 Diabetes Mellitus

Objective: To investigate the changes of plasma atherosclerosis index(AIP),nerve conduction velocity and other related clinical indexes in type 2 diabetic peripheral neuropathy patients and type 2 diabetic non-peripheral neuropathy patients,and to explore the relationship between AIP and diabetic peripheral neuropathy.Methods: 426 patients with type 2 diabetes mellitus were selected according to the inclusion criteria and exclusion criteria.The motor nerve conduction velocity of median nerve,peroneal nerve,tibial nerve and ulnar nerve were measured by electromyography(EMG).According to symptoms and signs and EMG results,all the patients were divided into two groups,namely,type 2 diabetic peripheral neuropathy group(DPN group,n=272)and type 2 diabetes non-peripheral neuropathy group(NDPN group,n=154).According to the AIP quartile value all participants were divided into four groups,group A of 107 cases(AIP <-0.1258),group B of 107 cases(-0.1258 ? AIP <0.04646),group C of 106 cases(0.04646?AIP <0.2617),group D of106 cases(AIP?0.2617).General clinical data were collected and fasting blood were drawn to measure fasting blood glucose(FBG),triglyceride(TG),total cholesterol(TC),low density lipids(TC),low density lipids(LDL),low density lipids(LDL-C),high density lipoprotein cholesterol(HDL-C),lipoprotein alpha,glycosylated hemoglobin(HbA1c),fasting insulin(FINS),urea nitrogen(BUN),Creatinine(Cr),24 h urinary albumin excretion rate(UAER).Calculate the insulin resistance index HOMA-IR = [fasting blood glucose level(FBG)× fasting insulin level(FINS)]/22.5.BMI = body weight(kg)/ height2(m2),AIP = Log [TG / HDL-C].SPSS19.0 was used to compare the differences between the two groups in general data,biochemical indexes,AIP and nerve conduction velocity,and to analyze the correlation between AIP and DPN.Results:(1)The AIP of type 2 diabetic peripheral neuropathy group was significantly higher than that of type 2 diabetic non-peripheral neuropathy group(P <0.05).The course of diabetes,TC,HbA1 c and UAER were significantly higher in DPN group.In DPN group,the nerve conduction velocity,HDL-C and FINS were lower than those in NDPN group,the difference was statistically significant(P <0.05).(2)The proportion of type 2 diabeticperipheral neuropathy in group A,B,C and D was 15.81%,25.37%,27.21% and 31.62%,respectively(P <0.05).The peroneal nerve MCV(bilateral),the tibial nerve MCV(bilateral),the ulnar nerve MCV(left),the median nerve SCV(bilateral),the sural nerve SCV(bilateral),the ulnar nerve SCV(bilateral)decreased with the increasing of AIP value,the difference was statistically significant(P <0.05).(3)Correlation analysis showed negative correlations between AIP and the median nerve MCV(bilateral,r=-0.279?-0.207,p < 0.05),the peroneal nerve MCV(right,r=-0.237,p < 0.05),the tibial nerve MCV(bilateral,r=-0.189?-0.198,p<0.05),the ulnar never MCV(left,r=-0.189?-0.198,p<0.05),the median nerve SCV(bilateral,r=-0.194?-0.212,p<0.05),the superficial peroneal nerve SCV(biateral,r=-0.217?-0.231,p<0.05),the sural nerve SCV(bilateral,r=-0.209,p<0.05),the ulnar nerve SCV(left,r=-0.361?-0.256,p<0.05)of DPN group patients.(4)Multivariate logistic regression analysis showed that AIP was an independent risk factor for type 2diabetic peripheral neuropathy(OR = 2.018,95% CI 1.005 ~ 3.966).Conclusion: Elevated plasma arteriosclerosis index is associated with type 2 diabetic peripheral neuropathy.