| Objective: To retrospectively analyze the relevant clinical data of patients with type 2 diabetic neuropathic pain in Yichun area,and to explore the related risk factors.At the animal level,observe whether agmatine alone and combined with gabapentin have a potential therapeutic effect on diabetic neuropathic pain model rats,and discuss its mechanism.Methods: A total of 273 patients with type 2 diabetes admitted to Yichun People’s Hospital from January 2019 to January 2020 were selected and divided into a pain group(DNP group,135 cases)and a non-pain group(NDNP group,138),and analyze the general data and blood routine,glycated hemoglobin,blood lipids,homocysteine levels of the two groups of patients retrospectively,Pearson analysis is used to calculate the correlation between DNP and various indicators,multiple logistic regression analysis of type 2 diabetes Risk factors related to the onset of neuropathic pain patients,ROC curve analysis and diagnostic value.At the animal level,a DNP rat model was constructed by intraperitoneal injection of streptozotocin(65 mg·kg-1),and Mechanical withdrawal Threshold and Thermal withdrawal Latency were used as observation indicators to evaluate the therapeutic effect of agmatine on DNP rats.Rats were sacrificed 24 hours after the last administration to collect L4-L6 segment spinal cord tissues.Western blot was used to detect the level of p-ERK and c-Fos protein expression.Results: There were no significant differences in age,gender,BMI,blood pressure,white blood cells,creatinine,urea nitrogen,uric acid,triglycerides,cholesterol,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol between the two groups.Compared with the NDNP group,the number of lymphocytes in the DNP group was significantly reduced,and the levels of neutrophils,NLR,glycated hemoglobin,and homocysteine were significantly increased,and the difference was statistically significant(P<0.05).Pearson correlation analysis showed that DNP was negatively correlated with lymphocyte values and positively correlated with neutrophils,NLR,Hb A1 c,and HCY.Multiple logistic regression analysis showed that NLR,Hb A1 c,and HCY were the risk factors for DNP;ROC curve showed that the areas under the curve of NLR,Hb A1 c,and HCY were 0.607,0.605,and 0.595,respectively,and the critical values for the diagnosis of DNP were 2.545,8.150,and 12.35,respectively.The sensitivity was 37.0%,60.0% and 37.0%,and the specificity was 79.7%,58.7% and 78.4%,respectively.At the animal level,compared with the normal group of rats,DNP rats had significantly reduced body weight,increased blood glucose,decreased MWT,and shortened TWL(P<0.01).After 14 days of continuous administration,agmatine had no significant effect on the body weight of DNP rats(P>0.05),agmatine could dose-dependently reduce blood glucose levels,and significantly increased MWT and TWL in rats(P<0.01),Western blot results showed that the level of p-ERK in the model group were increased(P<0.05),but after agmatine intervention,the p-ERK expression levels could be reduced(P<0.05).The MWT and TWL of the agmatine combined with gabapentin group were significantly higher than that of the model group,and the expression levels of p-ERK and c-Fos were lower than that of the model group(P<0.05).Conclusion: Gender,age,BMI,blood pressure,white blood cells,creatinine,urea nitrogen,uric acid,triglycerides,cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol levels are not related to the occurrence of diabetic neuropathic pain.NLR,glycated hemoglobin,and homocysteine are risk factors for diabetic neuropathic pain,which can be used to assist in the diagnosis of DNP and have a positive significance for the prevention and intervention of DNP.In the DNP model,agmatine alone and combined with gabapentin have a significant therapeutic effect on diabetic neuropathic pain,and its analgesic mechanism may be related to the regulation of blood glucose and the inhibition of spinal ERK signaling pathway. |
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