| Objective:To investigate the clinical features and related risk factors of 273hospitalized uygur patients with type 2 diabetes mellitus(T2DM)complicated with diabetic peripheral neuropathy(DPN),and to explore the correlation between serum Cystatin C(Cys C)and homocysteine(Hcy)with DPN,so as to provide the possible risk factors and treatment basis for early prevention and diagnosis and effective treatment of DPN.Methods:This study is a retrospective investigation,involving 273 uygur T2DM patients with complete data admitted and treated in the first affiliated hospital of xinjiang medical university from January 2017 to June 2018,including 158 males and 115 females,aged 37-79 years old,with a duration of diabetes mellitus of 1-36 years.All patients were divided into DPN group and NDPN group according to whether the patients were complicated with DPN.By measuring and comparing the general clinical data of patients in two groups,such as Cys C,Hcy and emg features.Statistical processing:all data were processed by SPSS 22.0 statistical software.The measurement data of the normal distribution are represented by(??s),the comparison between two samples is conducted by t test,and the comparisons between multiple samples of data of the normal distribution or the data converted to the normal distribution by arithmetic is conducted by anova.The counting data were expressed as?~2,with DPN as the dependent variable and each risk factors as the independent variable and correlation analysis between the Logistic regression data was conducted.ROC curve was used to analyze the cuing effect of Cys C,Hcy on DPN.The test level was set as 0.05,and the difference was statistically significant when p<0.05.Results:(1)Age,course of diabetes,smoking rate,waist circumference,FBG,2hPBG,HbA1c,Cys C,Hcy,and UA levels in the DPN group were significantly higher than those in the NDPN group,with statistically significant differences in the above indicators between the two groups(all P<0.05).(2)Motor nerve electrophysiological comparison between the two groups:the latency of medan nerve and tibial nerve in DPN group was longer than that in NDPN group.Median nerve and tibial nerve between DPN and NDPN group(P>0.05).NCV of median nerve and tibial nerve in DPN group was significantly lower than that in NDPN group(P<0.05).(3)Electrophysiological comparison of sensory nerves between the two groups:the latency of median nerve,ulnar nerve and common peroneal nerve in DPN group was longer than that in the simple diabetes people.Tibial nerve amplitudein DPN group was shorter than that in NDPN.NCV of median nerve,ulnar median nerve,tibial nerve and common peroneal nerve in DPN group was significantly lower than that in NDPN group(P<0.05).(4)The clinical distribution characteristics of abnormal NCV in DPN group:in DPN group 12patients(8.0%)had abnormal motor nerve(MCV),including 5 cases(41.67%)of median nerve and 3 cases(25.0%)of tibial nerve.Abnormal sensory nerve(SCV)of 103 cases(68.67%),including 51 cases(49.51%)of the median nerve,32 cases(31.07%)of tibial nerve,9 cases(8.74%)of ulnar nerve,6 cases(5.83%)of peroneal nerve.35 patients with combination of motor and sensory nerve abnormalities(23.33%),involving the double arm 7 cases(4.67%),double lowerlimbs in 116 cases(77.33%),the affected limb 27 cases(18.0%).Sensory nerve abnormality rate is obviously higher than that of motor nerve,lower limb involvement abnormal rate is significantly higher than that of the upper extremity involved,the difference was statistically significant(P<0.05).(5)In whether patients with DPN as dependent variable,there exists significant difference with single factor comparesion of indicators as independent variables and risk factors of DPN multifactor retrospective analysis,the results showed that age,long duration of diabetes,smoking and FBG,2hPBG,HbA1c,Cys C,Hcy levels have regression relationship with T2DM concurrent DPN,are independent risk factors for the development of T2DM and DPN.(6)Pearson correlation analysis showed that serum Cys C was positively correlated with the course of diabetes,HbAlc,FBG,2hPBG and Hcy(r values were 0.298,0.245,0.240,0.293,0.430,0.486,all P<0.001),but not correlated with other indicators(P>0.001).Serum Hcy was positively correlated with age,disease course,HbAlc,FBG,2hPBG,Cys C(r values were 0.232,0.305,0.325,0.340,0.430,0.486,all P<0.001),but not linearly correlated with other indicators(P>0.001).(7)According to ROC curve analysis,the area under the curve(AUC)of DPN inferred by Cys C and Hcy was 0.941 and 0.974,and the cut off values were 1.015 mg/L and 11.32 umol/L.Conclusion:T2DM patients,who are older,smoking,with longer duration of diabetes or with high FBG,HbA1c,Hcy,Cys C level are the risk factors of DPN.Nerve conduction velocity of DPN patients decreased to different degrees,and the rate of sensory nerve abnormality was significantly higher than that of motor nerveabnormality.The involvement of lower limb nerve was higher than upper limb,which may be related to its anatomical factors and pathogenesis.The positive correlation between serum Cystatin C and homocysteine suggests that the two may coordinate in the development of diabetic peripheral neuropathy,and early determinationsof serum Cystatin C and homocysteine may be of important value in the early diagnosis of diabetic peripheral neuropathy. |
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