Changes And Clinical Significance Of Serum PCSK9 Level In Patients With Type 2 Diabetic Peripheral Neuropathy

OBJECTIVE: Diabetic peripheral neuropathy(DPN)can cause damage to the peripheral nervous system throughout the body,and is one of the chronic complications of diabetes.The pathogenesis of DPN is complex and has not yet been fully understood.Some studies have shown that Proprotein convertase subtilisin/kexin type 9(PCSK9)is associated with type 2 diabetes,but no peripheral neuropathy has been reported.In this study,serum PCSK9 level of DPN population was detected and compared with type 2 diabetes without DPN.This study further analyzed the correlation between PCSK9 and diabetic peripheral neuropathy,blood glucose and blood lipid.Objective to investigate clinical significance of serum PCSK9 level in type 2 diabetic peripheral neuropathy.METHODS: In this study,129 T2 DM patients hospitalized in Hebei General Hospital from March 2018 to January 2020 were recruited as subjects.All the patients were examined by ankle reflex,acupuncture pain,vibration,pressure and sense of temperature.They were divided into two groups according to whether there is peripheral neuropathy or not,including 61 patients with simple diabetes(DM group)and 68 patients with diabetic peripheral neuropathy(DPN group).DM group was the control group and DPN group was the experimental group.General information of all patients was collected,and body mass index(BMI)was calculated based on height and weight.Serum PCSK9 levels of the subjects were determined by enzymatically linked immunosorbentassay with double antibody sandwich method.Fasting blood-glucoseand(FPG),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were determined by automatic biochemical analyzer.Hemoglobin A1c(Hb A1c)was determined by HPLC method.The differences of the above indicators between two groups were compared,and the correlation between serum PCSK9 and the above serological indicators was analyzed.Risk factors of DPN were analyzed by Logistic regression.SPSS26.0 statistical software was used for data processing and analysis,and P < 0.05 was considered statistically significant.Results:1.Comparison of general clinical data and biochemical indexes between DM and DPN groupThere were no significant differences in age,gender,BMI between the two groups(P > 0.05).The course of disease in DPN group was significantly longer than that in DM group(P < 0.05).There were no significant differences in TG and HDL-C level between two groups(P >0.05).The levels of FPG,Hb A1 c,TC and LDL-C in the DPN group were significantly higher than those in the DM group.2.Comparison of serum PCSK9 levels between DM and DPN groupSerum PCSK9 level in DPN group was significantly higher than that in DM group,and the difference was statistically significant(P < 0.05).3.Risk factors analysis for the occurrence of DPNMultivariate Logistic regression analysis showed that Hb A1c(OR=1.612,P=0.038),and serum PCSK9 level(OR=1.013,P=0.004)were risk factors for DPN.4.Correlation analysis between serum PCSK9 level and other clinical indicatorsCorrelation analysis showed that serum PCSK9 was positively correlated with FPG and Hb A1c(r=0.303,0.264,P=0.004,0.001).Conclusion:1.The levels of FPG,Hb A1 c,TC and LDL-C in patients with DPN were significantly higher than those in patients with diabetes alone.2.Patients with DPN were associated with a significant increase in serum PCSK9 levels.The serum PCSK9 level was positively correlated with FPG and Hb A1 c.3.PCSK9 is a risk factor for DPN and may be related to the occurrence and development of DPN.