Risk Factor Analysis of Type 2 Diabetic Peripheral Neuropathy Complicated with Microangiopathy

Enxian ZHU; Ben NIU; Lina TIAN; Yajuan XIE

doi:10.12259/j.issn.2095-610X.S20240807

Volume 45 Issue 8

Aug. 2024

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2024 > 45(8): 44-51

Enxian ZHU, Ben NIU, Lina TIAN, Yajuan XIE. Risk Factor Analysis of Type 2 Diabetic Peripheral Neuropathy Complicated with Microangiopathy[J]. Journal of Kunming Medical University, 2024, 45(8): 44-51. doi: 10.12259/j.issn.2095-610X.S20240807

Citation:

Enxian ZHU, Ben NIU, Lina TIAN, Yajuan XIE. Risk Factor Analysis of Type 2 Diabetic Peripheral Neuropathy Complicated with Microangiopathy[J]. Journal of Kunming Medical University, 2024, 45(8): 44-51. doi: 10.12259/j.issn.2095-610X.S20240807

Citation:

PDF( 639 KB)

Risk Factor Analysis of Type 2 Diabetic Peripheral Neuropathy Complicated with Microangiopathy

doi: 10.12259/j.issn.2095-610X.S20240807

1.
The 1st College of Clinical Medicine，Yunnan University of Traditional Chinese Medicine，Kunming Yunnan 650051
2.
Dept. of Geriatrics，The 1st People’s Hospital of Yunnan Province/Affiliated Hospital of Kunming University of Science and Technology，Kunming Yunnan 650034，China

Received Date: 2024-01-03
Available Online: 2024-07-06
Publish Date: 2024-08-05

Abstract

Abstract

Objective To investigate the risk factors of type 2 diabetic peripheral neuropathy （DPN） complicated with microangiopathy. Methods A total of 197 DPN patients hospitalized in the Department of Endocrinology of the First People's Hospital of Yunnan Province from November 1, 2021 to December 31, 2022 were retrospectively reviewed. Patients were divided into groups based on whether they had concurrent microvascular complications: 66 cases in the pure DPN group, 45 cases in the DPN combined with type 2 diabetic retinopathy （DR） group, 50 cases in the DPN combined with type 2 diabetic kidney disease （DKD） group, and 36 cases in the DPN combined with DR and DKD group. General conditions and relevant clinical indicators of the patients were collected to analyze the factors influencing the combination of DPN with microvascular complications. Results The prevalence of DPN alone was 33.50%, DPN combined with DR Was 22.84%, DPN combined with DKD was 25.38%, and DPN combined with DR and DKD was 18.27%. In the four groups, age, disease duration, history of hypertension, systolic blood pressure （SBP）, estimated glomerular filtration rate （eGFR）, creatinine （Cr）, blood urea nitrogen （BUN）, albumin （ALB）, albumin/globulin ratio （A/G）, free triiodothyronine （FT3）, fasting C-peptide （C-P）, two hours of C-peptide （C-P2）, fasting insulin （INS）, insulin 2 hours after a meal （INS2h）, time in range （TIR） for glucose, visceral fat area （VFA）, and standard deviation of NN intervals （SDNN） for sinus rhythm all show statistically significant differences （P < 0.05）. The results of logistic regression analysis show that compared to DPN patients, age （OR = 0.882, 95%CI: 0.814～0.956, P = 0.002） and eGFR （OR=0.934, 95%CI: 0.886～0.985, P = 0.011） are protective factors for those with DPN and DR, while SBP （OR = 1.030, 95%CI: 1.003～1.058, P = 0.028） is an independent risk factor. When comparing DPN patients with those who have DPN and DKD, SBP （OR = 1.026, 95%CI: 1.001～1.052, P = 0.042） is an independent risk factor. Comparing DPN patients with those who have DPN and both DR and DKD, FT3 （OR = 0.468, 95%CI: 0.224～0.976, P = 0.43） is a protective factor, while SBP （OR = 1.029, 95%CI: 1.000～1.059, P = 0.047） and VFA （OR = 1.027, 95%CI: 1.006～1.049, P = 0.013） are independent risk factors. Conclusion Elevated systolic blood pressure and visceral fat are high-risk factors for the development of microvascular complications in diabetic peripheral neuropathy （DPN）, contributing to the occurrence and progression of microvascular complications in DPN.
- Type 2 diabetic peripheral neuropathy,
- Type 2 diabetic microangiopathies,
- Risk factor

FullText(HTML)

References(36)

References

[1]	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020 年版)[J]. 国际内分泌代谢杂志,2021,41(5):482-548. doi: 10.3760/cma.j.cn121383-20210825-08063
[2]	吴遵平,吴利利. 基于Apriori模型分析糖尿病周围神经病变患者的联合用药情况[J]. 海峡药学,2022,34(8):118-121.
[3]	Cheng Y,Cao W,Zhang J,et al. Determinants of diabetic peripheral neuropathy and their clinical significance: A retrospective cohort study[J]. Front Endocrinol (Lausanne),2022,13:934020. doi: 10.3389/fendo.2022.934020
[4]	王志平, 熊英琼. 电流感觉阈值检测仪的临床应用[J]. 江西中医药大学学报,2017,(3):115-117.
[5]	中华医学会糖尿病学分会微血管并发症学组. 中国糖尿病肾脏病防治指南(2021年版)[J]. 中华糖尿病杂志,2021,13(8):762-784. doi: 10.3760/cma.j.cn115791-20210706-00369
[6]	张燕. 2型糖尿病周围神经病变和其他微血管病变相互关系的研究[D]. 重庆: 重庆医科大学,2013.
[7]	马丽丽. 2型糖尿病微血管病变的相关危险因素分析[J]. 医学食疗与健康,2023,21(13):156-158.
[8]	王霞,严靓,李伟琴,等. 不同糖尿病微血管病变患者血清N-钙黏蛋白、E-钙黏蛋白水平变化及其诊断效能分析[J]. 山东医药,2023,63(32):11-15. doi: 10.3969/j.issn.1002-266X.2023.32.003
[9]	徐瑞君,韦玉和,沈文明,等. 中性粒细胞与淋巴细胞比值与2型糖尿病血管病变的相关性研究[J]. 齐齐哈尔医学院学报,2020,41(3):267-270. doi: 10.3969/j.issn.1002-1256.2020.03.002
[10]	Woolf S H,Davidson M B,Greenfield S. Controlling blood glucose levels in patients with type 2 diabetes mellitus. An evidence-based policy statement by the American Academy of Family Physicians and American Diabetes Association[J]. J Fam Pract,2000,49(5):453-460.
[11]	Zhong J B,Yao Y F,Zeng G Q,et al. A closer association between blood urea nitrogen and the probability of diabetic retinopathy in patients with shorter type 2 diabetes duration[J]. Sci Rep,2023,13(1):9881. doi: 10.1038/s41598-023-35653-z
[12]	Du K,Luo W. Association between blood urea nitrogen levels and diabetic retinopathy in diabetic adults in the United States (NHANES 2005-2018)[J]. Front Endocrinol (Lausanne),2024,15:1403456. doi: 10.3389/fendo.2024.1403456
[13]	Wang X,Yang W,Zhu Y,et al. Genomic DNA methylation in diabetic chronic complications in patients with type 2 diabetes mellitus[J]. Front Endocrinol (Lausanne),2022,13:896511. doi: 10.3389/fendo.2022.896511
[14]	Wang G X,Fang Z B,Li J T,et al. The correlation between serum albumin and diabetic retinopathy among people with type 2 diabetes mellitus: NHANES 2011-2020[J]. PLoS One,2022,17(6):e0270019. doi: 10.1371/journal.pone.0270019
[15]	Adnan Khalaf M,Ghassan Zainal I. Investigation of antioxidant markers in diabetic patients[J]. Arch Razi Inst,2021,76(5):1453-1460.
[16]	Cai Y W,Zhang H F,Gao J W,et al. Serum albumin and risk of incident diabetes and diabetic microvascular complications in the UK Biobank cohort[J]. Diabetes Metab,2023,49(5):101472. doi: 10.1016/j.diabet.2023.101472
[17]	Chen J,Huang Y,Liu C,et al. The role of C-peptide in diabetes and its complications: An updated review[J]. Front Endocrinol (Lausanne),2023,14:1256093. doi: 10.3389/fendo.2023.1256093
[18]	Vejrazkova D,Vankova M,Lukasova P,et al. Insights into the physiology of C-peptide[J]. Physiol Res,2020,69(Suppl 2):S237-S243.
[19]	Ido Y,Vindigni A,Chang K,et al. Prevention of vascular and neural dysfunction in diabetic rats by C-peptide[J]. Science,1997,277(5325):563-566. doi: 10.1126/science.277.5325.563
[20]	Johansson B L,Kernell A,Sjöberg S,et al. Influence of combined C-peptide and insulin administration on renal function and metabolic control in diabetes type 1[J]. J Clin Endocrinol Metab,1993,77(4):976-981.
[21]	Wahren J,Foyt H,Daniels M,et al. Long-acting C-peptide and neuropathy in type 1 diabetes: A 12-month clinical trial[J]. Diabetes Care,2016,39(4):596-602. doi: 10.2337/dc15-2068
[22]	戴艳环,陈莉,张伟. 2型糖尿病患者血清胰岛素及C肽释放水平变化的探讨[J]. 糖尿病新世界,2023,26(23):52-54,62.
[23]	Mayeda L,Katz R,Ahmad I,et al. Glucose time in range and peripheral neuropathy in type 2 diabetes mellitus and chronic kidney disease[J]. BMJ Open Diabetes Res Care,2020,8(1):e000991. doi: 10.1136/bmjdrc-2019-000991
[24]	叶倩呈,黄洁微,周佩如. 葡萄糖目标范围内时间与糖尿病慢性并发症的相关性研究进展[J]. 循证护理,2022,8(3):322-325. doi: 10.12102/j.issn.2095-8668.2022.03.007
[25]	周侠,安秀敏,潘明麟,等. 2型糖尿病及其并发症与自主神经功能的关系探讨[J]. 医学研究杂志,2017,46(11):106-110,120. doi: 10.11969/j.issn.1673-548X.2017.11.026
[26]	Chen M,Wang Y,Feng P,et al. Association between age at type 2 diabetes onset and diabetic retinopathy: A double-center retrospective study[J]. J Diabetes Res,2023,2023:5919468.
[27]	蔡文瑶,杨丽辉,阿米娜. 2型糖尿病患者发生糖尿病视网膜病变的危险因素分析[J]. 西藏医药,2023,44(2):68-70.
[28]	赖丽平,刘贺,黄锡岚,等. 2型糖尿病患者的糖尿病视网膜病变患病率及危险因素[J]. 广西医学,2022,44(4):370-375.
[29]	陶俊,周漫,李艳. 2型糖尿病病人估算肾小球滤过率与糖尿病视网膜病变的相关性研究[J]. 安徽医药,2021,25(10):1954-1957. doi: 10.3969/j.issn.1009-6469.2021.10.011
[30]	温良,张继祥. 2型糖尿病患者肾小球滤过率与糖尿病视网膜病变的相关关系研究[J]. 中国实用医药,2019,14(8):54-56.
[31]	Samsu N. Diabetic nephropathy: challenges in pathogenesis,diagnosis,and treatment[J]. Biomed Res Int,2021,2021:1497449.
[32]	张健,胡怡. 2型糖尿病患者并发糖尿病肾病的危险因素及Nomogram风险预测模型构建[J]. 广西医科大学学报,2023,40(11):1843-1849.
[33]	张杉杉,纪锴,王艳,等. 内脏脂肪面积与2型糖尿病患者周围神经病变的相关性分析[J]. 中国糖尿病杂志,2022,30(10):741-745.
[34]	Wu Y,Wan Q,Xu Y,et al. Lower visceral fat area in patients with type 2 diabetic peripheral neuropathy[J]. Diabetes Metab Syndr Obes,2022,15:3639-3654. doi: 10.2147/DMSO.S388330
[35]	Zheng H,Sun W,Zhang Q,et al. Proinflammatory cytokines predict the incidence of diabetic peripheral neuropathy over 5 years in Chinese type 2 diabetes patients: A prospective cohort study[J]. EClinicalMedicine,2020,31:100649.
[36]	陶琪,毛樱. 甲状腺激素及抗体表达水平与糖尿病周围神经病变的相关性分析[J]. 中国现代医生,2023,61(5):43-46,51.

Relative Articles(20)

Relative Articles

[1]	Siqi WU, Gang CHEN, Yishuang XIAO. The Correlation between Routine Blood Indicators and Severity of Retinopathy of Prematurity. Journal of Kunming Medical University, 2024, 45(5): 130-135. doi: 10.12259/j.issn.2095-610X.S20240520
[2]	Shujie ZHOU, Ling ZHAO, Tingyu KE. Correlation Analysis between the Common Clinical Indexes and Diabetic Foot Ulcer. Journal of Kunming Medical University, 2024, 45(1): 61-66. doi: 10.12259/j.issn.2095-610X.S20240110
[3]	You HUANG, Guohui LI, Duli LIU, Zizi YU, Mei ZUO, Qin LI, Le CAI. Prevalence of Hypertension and Its Relationship with Clustering of Risk Factors of Cardiovascular Diseases in The Elderly Between Han Majority and Ha Ni Ethnic Minority in Rural District of Mojiang County of Yunnan Province. Journal of Kunming Medical University, 2024, 45(9): 1-7.
[4]	Jingshan CHEN, Li LI, Shili SHANG, Guoyong HE, Wenjing ZHOU, Sha LI, Di ZHANG, Yonglan LIU, Jun LI. Correlation Analysis between Pathological Features of IgA Nephropathy and Dyslipidemia. Journal of Kunming Medical University, 2023, 44(1): 47-53. doi: 10.12259/j.issn.2095-610X.S20230111
[5]	Weijie LI, Liqin CHEN, Yaling LI, Yonghui HAN, Xiaojuan LI, Fendong YAN. Epidemiology, Clinical Characteristics and Risk Factors of 148 Severe Pertussis Cases in Yunnan. Journal of Kunming Medical University, 2022, 43(8): 145-149. doi: 10.12259/j.issn.2095-610X.S20220824
[6]	Weimin LU, Xiaotao YANG, Ying ZHU, Yi HUANG, Houyu CHEN, Haifeng JIN, Yanchun WANG. Clinical Features and Risk Factors for Critical Cases of Scrub Typhus in 175 Children. Journal of Kunming Medical University, 2022, 43(8): 72-80. doi: 10.12259/j.issn.2095-610X.S20220814
[7]	Li-xuan YAO, Ben NIU, Wei YUE, Wen-lin ZHOU, Ya-ting ZHANG. Correlation Between Hepatitis C Virus Infection and Type 2 Diabetes Mellitus. Journal of Kunming Medical University, 2021, 42(8): 83-89. doi: 10.12259/j.issn.2095-610X.S20210815
[8]	Ze-zu MENG, Hang XIAN, Xiao-jin HOU, Shi-lei WEI, Ji MA, Rui ZHAO, Rui Cong. Analysis of the Risk Factors Associated with Vascular Crisis after the Digits Replantation. Journal of Kunming Medical University, 2021, 42(1): 130-134. doi: 10.12259/j.issn.2095-610X.S20210122
[9]	Chen Xu Jia , Wang Xiao Xiao , Ye Rui , Huang Yong Ping , Li Li . The Prevalence of Peripheral Arterial Disease and Its Risk Factors among Patients with Type 2 Diabetes in Community. Journal of Kunming Medical University, 2018, 39(02): 94-99.
[10]	Yang Ze Xing . . Journal of Kunming Medical University,
[11]	Ma Min . . Journal of Kunming Medical University,
[12]	Zhu Zhao . . Journal of Kunming Medical University,
[13]	Liu Yi . . Journal of Kunming Medical University,
[14]	Li Yan Yuan . . Journal of Kunming Medical University,
[15]	Wang Zhi Min . . Journal of Kunming Medical University,
[16]	Ou Yang Xin . . Journal of Kunming Medical University,
[17]	Yang Mao Lin . . Journal of Kunming Medical University,
[18]	Zhu Jing . The Potential Risk Factors Analysis of HIV/STD Infection in Vietnamese Cross-border Female Sex Workers. Journal of Kunming Medical University,
[19]	Zhang Xue Yu . The Correlation between Prevalence of Cardiovascular Diseases and Clustering of Risk Factors in Guandu District of Kunming. Journal of Kunming Medical University,
[20]	Yang Qiu Ping . . Journal of Kunming Medical University,