尿微量白蛋白／尿肌酐比值与2型糖尿病周围神经病变的相关性分析

摘要

目的：探讨尿微量白蛋白／尿肌酐比值（ UACR）与2型糖尿病老年患者周围神经病相关性。方法2型糖尿病患者161例按照是否合并周围神经病变分为糖尿病周围神经病变组（ DPN组，n＝102）和非糖尿病周围神经病变组（NDPN组，n＝59）；比较两组间一般临床资料、生化指标检查项目、UACR等差异，利用Logistic回归模型分析周围神经病变的相关危险因素。结果 DPN组患者的糖尿病病程、空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）、低密度脂蛋白胆固醇（LDL－C）、UACR水平显著高于NDPN组，空腹C肽显著低于对照组（均P＜0．05）；Logistic回归分析显示：糖尿病病程、FPG、2hPG、HbA1c、UACR是患者周围神经病变发生的高危因素（ P＜0．05）；UACR预测周围神经病变发生的ROC曲线下面积为0．835，敏感性和特异性分别为82．9％和85．1％；最佳诊断点为11．14 mg／g。结论2型糖尿病患者UACR与其血糖相关指标呈正相关，且是周围神经病变的高危因素。%Objective To explore the correlation of urine trace albumin/creatinine ratio ( UACR) to peripheral neuropathy in type 2 diabetes patients .Method 161 patients with type 2 diabetes were divided into diabetes peripheral neuropathy group (DPN group, n=102) and the diabetic peripheral neuropathy group (NDPN group, n=59) according to the peripheral neuropathy.The general clinical data, biochemical index, and UACR of the two groups were compared.Then the Logistic regression model was used to analyze the related risk factors resulting in peripheral neuropathy .Findings The diabetes duration, fasting plasma glucose (FPG), 2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), and UACR of the DPN group were significantly higher than those of the NDPN group (P<0.05).The fasting C peptide of the DPN group was significantly lower than that of the NDPN group (P<0.05);Logistic regression analysis showed that the diabetes duration , FPG , 2hPG, HbA1c, UACR were high risk factors for DPN (P<0.05).The ROC curve of UACR prediction of peripheral neuropathy was 0.835.The sensitivity and specificity were 82.9%and 85.1% respectively.The best diagnostic point was 11.14 mg/g.Conclusion UACR in patients with type 2 diabetes is positively correlated with related blood sugar index and is the risk factor of peripheral neuropathy .