| Objective The purpose of our study was to investigate the relationship between?-cell function and sudomotor function in patients with type 2 diabetes mellitus?T2DM?.Methods The data of 385 patients with type 2 diabetes who were hospitalized at the department of Endocrinology,Eastern Theater Command Hospital?Nanjing General Hospital of Nanjing Military Command?from March 2016 to May 2018 were collected.General clinical information and laboratory assays were collected.Sudomotor function was assessed by SUDOSCAN using the mean hands electrochemical skin conductance?HESC?,the mean feet electrochemical skin conductance?FESC?,asymmetry ratio of hands?HASYM?and asymmetry ratio of feet?FASYM?.Both HESC and FESC>60?s was considered normal and ESC<60?S in either FESC or HFEC was considered abnormal.Basal insulin secretion was assessed by homeostasis model of assessment of?-cell?HOMA-??.Early-phase insulin secretion function was determined by the ratio of the 30 min increment in C-peptide concentration to the 30 min increment in glucose concentration ??C-P30/?G30?and the ratio of the 30 min increment in insulin concentration to the30 min increment in glucose concentration??I30/?G30?.Total?-cell function was determined by ratio of the total area under the curve of C-peptide in 120 min to the total area under the curve of glucose in 120 min(C-PAUC/GAUC)and ratio of the total area under the curve of insulin in 120 min to the total area under the curve of glucose in 120 min(IAUC/GAUC).Spearman correlation analysis and multiple linear stepwise regression analysis were carried out.Logistic regression analysis was performed to determine the effects of risk factors on sudomotor dysfunction.Results 1.Compared with the normal sudomotor function group,diabetes duration and age were higher[7.00?3.00,11.00?vs 5.00?1.50,7.00?,z=-4.563;58.33±11.60 vs52.43±11.88,t=-4.572,all P<0.001)]and?C-P30/?G30[0.19?0.08,0.30?vs0.30?0.19,0.53?,z=-5.495,P<0.001],?I30/?G30[1.47?0.67,3.28?vs2.26?1.28,4.65?,z=-3.897,P<0.001],C-PAUC/GAUC[0.07?0.04,0.16?vs 0.12?0.06,0.25?,z=-3.894,P<0.001)],IAUC/GAUC[2.79?0.76,6.35?vs3.30?1.35,8.32?,z=-2.092,P<0.05)]were lower in sudomotor dysfunction group.2.We found that HESC and FESC values all progressively increased from the first to the third?C-P30/?G30 tertiles?P<0.001?.3.Spearman correlation analysis showed that?C-P30/?G30 was positively correlated with HESC and FESC?the coefficient r was0.306,0.304,respectively,P<0.001?and negatively correlated with FASYM?the coefficient r was-0.109;P<0.05?.In addition,?C-P30/?G30 was also positively correlated with HESC and FESC?the coefficient r was 0.272,0.233,respectively;P<0.001?.4.Multiple linear stepwise regression analysis showed that?C-P30/?G30,diabetes duration,age,HbA1cc and plasma uric acid were associated with sudomotor function.5.Logistic regression analysis showed that lower?C-P30/?G30,diabetic duration,age and plasma uric acid were independent risk factors for sudomotor dysfunction.Conclusion Lower?C-P30/?G30 is an independent risk factor for sudomotor dysfunction.Thus,our results suggest that evaluating sudomotor function is necessary for physicians to screen for diabetic peripheral neuropathy?DPN?in patients with impaired early-phase?-cell function. |
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