Relationship Between Serum Ferritin And Homocysteine And Peripheral Neuropathy In Elderly Patients With Type 2 Diabetes

ObjectTo observe the levels of Serum Ferritin(SF)?Homocysteine(Hey)in elderly patients with peripheral neuropathy of type 2 diabetes,and to explore the role of both in neuropathy,and to further analyze the predictive value of serum ferritin and homocysteine in the development of peripheral neuropathy in elderly patients with type 2 diabetes.Methods1.From March 2019 to September 2019,99 hospitalized patients with type 2 diabetes mellitus were enrolled in the secretory department of The first affiliated Hospital of Zhengzhou University,including 51 patients with type 2 diabetes mellitus(DM group):34 males and 17 females,with an average age of(62.86 � 1.41)years;48 patients with peripheral neuropathy(DPN group),30 males and 18 females,the average age was(68.12�0.93)years;and 45 healthy persons were selected at the same time(NC group),22males and 23 females,average age(60.75�0.63)years.Then,according to different levels of serum ferritin and homocysteine,all participants were divided into four groups(serum ferritin was defined as 300ng/ml,homocysteine was defined as 15umol/L),and high levels of homocysteine were combined with high levels of serum ferritin(group A),with A total of 27 cases;High homocysteine with normal serum ferritin group(group B),a total of 14 cases;Normal level of homocysteine synthesis with high level of serum ferritin group(group C),a total of 58 cases;Normal level of homocysteine with normal level of serum ferritin group(group D),a total of 45 cases.2.Collect all the subjects' general information,including age,gender,the course of diabetes in DM group and DPN group,duration of diabetes glycated hemoglobin(HbA1c),serum ferritin(SF),homocysteine(Hcy),the levels of vitamin B12(VitB12),simultaneous determination in inhibition C(CysC),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C).3.The measurement data of normal distribution were expressed as mean �standard deviation,skewness distribution as median(25%,75%),and classification variables as%.Analysis of variance was used for the comparison of the mean of general measurement indexes and biochemical indexes among the groups.One-way analysis of variance was used for the comparison between the groups with homogeneous variance,and LSD test was used for the comparison between the two groups.Kruskal-wallis rank sum test was used for comparison between groups with unequal variances,and Bonferroni method was used for comparison between pairs.The chi-square test is used for rate comparisons.Pearson correlation analysis was performed to analyze the correlation between serum ferritin and homocysteine and each indicator,and Logistic regression model was further applied to analyze the influencing factors of peripheral neuropathy in elderly patients with type 2 diabetes mellitus.Meanwhile,ROC curve was used to analyze SF and Hcy to predict the occurrence of DPN.Results1.There was significant difference in HbA1c,SF,Hcy,VitB12,TC,TG,HDL-C among the NC?DM?DPNgroups,but there was no significant difference in the course of disease between DM group and DPN group.The level of HbA1c,SF,Hcy,TC,TG in NC group,DM group and DPN group increased in turn,while the level of HDL-C,VitB12 decreased in turn,the difference was statistically significant(P<0.05).2.Compared with DM group,age,HbA1c,SF,Hcy,CysC level and VitB12 level in DPN group were significantly higher than those in DPN group(P<0.05).3.Pearson correlation analysis showed that SF was positively correlated with HbA1c,Hcy,TC,LDL-C,HDL-C(?=0.239,0.204,0.211,0.250,0.221,P=0.004,0.014,0.000,0.000,0.000);Hcy was positively correlated with age and HbA1c,SF(?=0.309,0.173,0.204,P=0.000,0.038,0.014),and negatively correlated with VitB12,CysC(?=-0.335?-0.140,P=0.000?0.005).4.With or without peripheral neuropathy as the dependent variable,Logistic regression analysis was performed on elderly patients with type 2 diabetes and it was found that SF and Hcy were the factors influencing peripheral neuropathy.5.The prevalence of type 2 diabetes in elderly patients with hyperferrinemia and HHcy was 81.48%,the prevalence of diabetes in HHcy patients was 78.57%,and the prevalence of diabetes in hyperferrinemia patients was 75.86%,all of which were statistically significant compared with the normal group(P<0.05).The prevalence of DPN in elderly patients with hyperferrinemia and HHcy was 72.73%,which was statistically significant compared with the normal group(P<0.05),but not statistically significant compared with the other groups.6.ROC curve results showed that the optimal cut-off point,sensitivity,specificity and AUC values of SF and Hcy for DPN diagnosis were 379.09ng/ml,79.2%,44.1%and 0.635,respectively.13.74umol/L,65.6%,60.8%,0.660.The AUC value of SF combined with Hcy in the diagnosis of DPN was 0.726,the sensitivity was 82.6%,and the specificity was 50.1%.conclusionSerum ferritin and homocysteine levels were elevated in elderly patients with type 2 diabetic peripheral neuropathy,which were the risk factors for the occurrence of DPN.Regular combined detection of serum ferritin and homocysteine may have important significance in predicting the occurrence of type 2 diabetic peripheral neuropathy.