摘要
目的 探讨动态血糖监测(CGM)参数与2型糖尿病周围神经病变(DPN)患者神经传导、炎症因子及病情严重程度的关系。方法 前瞻性选取2020年3月至2024年8月在该院就诊的148例DPN患者(DPN组)、62例单纯2型糖尿病患者(T2DM组)和在该院体检的51例健康志愿者(对照组)作为研究对象,根据震动感觉阈值将DPN患者分为轻度组(50例)、中度组(54例)和重度组(44例)。所有DPN患者均进行CGM采集血糖参数,并通过表面肌电仪测定运动神经传导速度(MNCV)和感觉神经传导速度(SNCV),同时采血检测炎症因子肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1β、IL-6水平。分析CGM参数与MNCV、SNCV、TNF-α、IL-1β、IL-6以及DPN病情严重程度的相关性。结果 DPN组平均血糖波动幅度(MAGE)、日内最大血糖波动幅度(LAGE)、全天血糖平均值(MBG)、全天血糖标准差(SDBG)、空腹血糖变异系数(FBG-CV)及血清TNF-α、IL-1β、IL-6水平均高于T2DM组和对照组(P<0.05),葡萄糖目标范围内时间(TIR)、MNCV、SNCV均低于T2DM组和对照组(P<0.05)。重度组MAGE、LAGE、FBG-CV及血清TNF-α、IL-1β、IL-6水平均高于中度组和轻度组(P<0.05),MNCV、SNCV均低于中度组和轻度组(P<0.05)。DPN患者MAGE、LAGE、FBG-CV与MNCV、SNCV呈负相关(P<0.05),与血清TNF-α、IL-1β、IL-6水平及病情严重程度呈正相关(P<0.05)。结论 DPN患者CGM参数异常与神经传导速度减慢、机体炎症反应及病情加重有关。
Objective To explore the relationship between the continuous glucose monitoring(CGM)parameters with the nerve conduction,inflammatory factors and disease severity in the patients with type 2 diabetic peripheral neuropathy(DPN).Methods A total of 148 patients with DPN(DPN group)and 62 patients with type 2 diabetes mellitus(T2DM group)visiting in this hospital and 51 healthy volunteers(control group)undergoing physical examinations in this hospital from March 2020 to August 2024 were prospectively selected as the research subjects.The DPN patients were divided into the mild(50 cases),moderate(54 cases)and severe(44 cases)groups based on the vibration perception threshold value.All DPN patients underwent CGM to obtain glucose parameters,their motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)were measured by the surface electromyography,and the blood samples were collectd for detecting of the inflammatory factors tumor necrosis factor-α(TNF-α),interleukin(IL)-1βand IL-6.The correlation between the CGM parameters with MNCV,SNCV,TNF-α,IL-1β,IL-6 and disease severity was analyzed.Results The mean amplitude of glycemic excursions(MAGE),largest amplitude of daily glycemic excursions(LAGE),mean blood glucose(MBG),standard deviation of blood glucose(SDBG),fasting blood glucose coefficient of variation(FBG-CV)and serum TNF-α,IL-1βand IL-6 levels in the DPN group were all higher than those in the T2DM group and control group(P<0.05),while the time in range(TIR),MNCV and SNCV were all lower than those in the T2DM group and control group(P<0.05).MAGE,LAGE,FBG-CV,serum TNF-α,IL-1βand IL-6 levels in the severe group were all higher than those in the moderate group and mild group(P<0.05),while MNCV and SNCV were lower than those in the moderate group and mild group(P<0.05).In DPN patients,MAGE,LAGE and FBG-CV were negatively correlated with MNCV and SNCV(P<0.05),and positively correlated with serum TNF-α,IL-1βand IL-6 levels,and disease severity(P<0.05).Conclusion The abnormality of CGM parameters in DPN patients is related with the slowed nerve conduction velocity,body inflammatory response and disease aggravation.
作者
汪俊
刘德翠
孙艳雷
WANG Jun;LIU Decui;SUN Yanlei(Department of General Practice Medicine,Nanjing Municipal Hospital of Chinese Medicine,Nanjing,Jiangsu 210000,China)
出处
《检验医学与临床》
2025年第22期3090-3094,共5页
Laboratory Medicine and Clinic
基金
江苏省卫生健康委员会科研项目(S2020071)。
关键词
2型糖尿病
糖尿病周围神经病变
神经传导
炎症因子
病情严重程度
动态血糖监测
type 2 diabetes mellitus
diabetic peripheral neuropathy
nerve conduction
inflammatory factors
severity of illness
continuous glucose monitoring
