2024 年第 2 期 第 19 卷

血清胎球蛋白B水平与2型糖尿病合并糖尿病周围神经病变的相关性研究

Correlation of serum fetuin-B level and type 2 diabetes mellitus complicated with peripheral neuropathy

作者：刘亚娟罗晓红董俐王扶卉吴小芬许瑞元魏红红

英文作者：Liu Yajuan Luo Xiaohong Dong Li Wang Fuhui Wu Xiaofen Xu Ruiyuan Wei Honghong

单位：中国人民解放军联勤保障部队第九四〇医院内分泌科，兰州730050

英文单位：Department of Endocrinology the 940th Hospital of Joint Logistics Support Force of the Chinese People′s Liberation Army Lanzhou 730050 China

关键词：2型糖尿病；胎球蛋白B；糖尿病周围神经病变；炎症反应

英文关键词：Type2diabetesmellitus;Fetuin-B;Diabeticperipheralneuropathy;Inflammatoryreaction

• 摘要：

• 目的  探讨血清胎球蛋白B水平与2型糖尿病（T2DM）合并糖尿病周围神经病变（DPN）的相关性。方法  选取2022年1—10月在中国人民解放军联勤保障部队第九四〇医院内分泌科住院治疗的145例T2DM患者作为研究对象。根据是否合并DPN分为单纯T2DM组（79例）和T2DM合并DPN组（66例），另选取同期本院体检中心25名体检健康者作为健康对照组。收集所有受试者的一般资料、糖脂代谢指标及生化相关指标。采用酶联免疫吸附试验法检测所有受试者的血清胎球蛋白B水平并进行组间比较。采用Spearman相关性分析方法分析胎球蛋白B水平与其他指标的相关性。采用二元Logistic回归分析方法分析T2DM合并DPN的影响因素。采用受试者工作特征曲线评价血清胎球蛋白B对T2DM合并DPN的预测效能。结果  T2DM合并DPN组的胎球蛋白B水平显著高于单纯T2DM组和健康对照组，单纯T2DM组的胎球蛋白B水平高于健康对照组，差异均有统计学意义（均P<0.05）。相关性分析结果显示，胎球蛋白B与糖尿病病程(r=0.369，P<0.001)、空腹血糖（r=0.307，P<0.001）、糖化血清蛋白（r=0.411，P<0.001）、糖化血红蛋白（r=0.366，P<0.001）、总胆固醇（r=0.366，P<0.001）、低密度脂蛋白胆固醇（r=0.161，P=0.036）及血尿素氮（r=0.166，P=0.030）均呈显著正相关；与空腹胰岛素(r=-0.309，P<0.001)、高密度脂蛋白胆固醇(r=-0.209，P=0.006)、估算肾小球滤过率（r=-0.274，P<0.001）均呈显著负相关。Logistic回归分析结果显示，高胎球蛋白B水平为T2DM合并DPN的危险因素（P<0.05）。血清胎球蛋白B对T2DM合并DPN具有一定预测价值，受试者工作特征曲线下面积为0.826（95%置信区间：0.752～0.900，P=0.010）。结论  血清胎球蛋白B水平升高是T2DM合并DPN的危险因素。血清胎球蛋白B对T2DM合并DPN具有一定预测价值。

• Objective  To explore the correlation between serum fetuin-B level and type 2 diabetes mellitus (T2DM) complicated with diabetic peripheral neuropathy (DPN). Methods  Totally 145 T2DM patients admitted to Department of Endocrinology, the 940th Hospital of Joint Logistics Support Force of the Chinese People′s Liberation Army from January to October 2022 were included. According to whether to merge DPN， they were divided into simple T2DM group(79 cases) and T2DM combined with DPN group(66 cases). In addition， 25 healthy volunteers from the physical examination center of the hospital were selected as the healthy control group. General information, glucose and lipid metabolism indicators, and biochemical related indicators of all subjects were collected. The serum fetuin-B levels of all subjects were detected using enzyme-linked immunosorbent assay and compared among groups. The Spearman correlation analysis method was used to analyze the correlation between serum fetuin-B level and other indicators. The binary Logistic regression analysis method was used to analyze the influencing factors of T2DM combined with DPN. The receiver operating characteristic curve was used to evaluate the predictive efficacy of fetuin-B in T2DM combined with DPN. Results  The levels of fetuin-B in the T2DM combined with DPN group were significantly higher than those in the simple T2DM group and the healthy control group, and the level of fetuin-B in the simple T2DM group was higher than that in the healthy control group(all P<0.05). The results of correlation analysis showed that fetuin-B was positively correlated with the course of diabetes mellitus(r=0.369, P<0.001), fasting plasma glucose(r=0.307, P<0.001), glycosylated serum protein(r=0.411, P<0.001), glycosylated hemoglobin (r=0.366, P<0.001), total cholesterol(r=0.366, P<0.001), low-density lipoprotein cholesterol(r=0.161, P=0.036), and blood urea nitrogen(r=0.166, P=0.030); there was a significant negative correlation with fasting insulin(r=-0.309, P<0.001), high-density lipoprotein cholesterol(r=-0.209, P=0.006), and estimated glomerular filtration rate(r=-0.274, P<0.001). The Logistic regression analysis showed that high levels of fetuin-B were a risk factor for T2DM combined with DPN(P<0.05). Serum fetuin-B has certain predictive value for T2DM combined with DPN, with an area under the receiver operating characteristic curve of 0.826(95% confidence interval: 0.752-0.900, P=0.010). Conclusions    Elevated level of serum fetuin-B is a risk factor for DPN in patients with T2DM. High fetuin-B levels are associated with the occurrence and development of DPN.