Association of Serum Ghrelin Level with Type 2 Diabetic Peripheral Neuropathy

doi:10.12114/j.issn.1007-9572.2020.00.424

Abstract

Abstract: Background　Ghrelin is a kind of endogenous gastrointestinal peptide hormones，which may improve diabetic nerve damage.But few human in vivo studies are about the relationship between ghrelin and diabetic peripheral neuropathy （DPN）.DPN has different stages including subclinical and symptomatic DPN with the development of the disease in clinical practice，and the role of ghrelin in each stage of DPN is unclear.Objective　To explore whether serum ghrelin plays a role in each stage of DPN in type 2 diabetics.Methods　Participants were 247 type 2 diabetics who were recruited from Tangshan Gongren Hospital from July 2017 to December 2018，and were divided into non-DPN group （n=129），subclinical DPN group（n=57） and definite DPN group （n=61） according to DPN diagnostic criteria in 2017 Chinese Guidelines for the Prevention and Treatment of Type 2 Diabetes.Serum ghrelin levels in the three groups were compared.Pearson correlation analysis，Spearman rank correlation analysis or partial correlation analysis was used to analyze the relationship of ghrelin level with clinical data.Multivariate Logistic regression was used to identify the influencing factors of abnormal nerve conduction function，subclinical DPN and definite DPN.Results　There were significant differences in average serum ghrelin levels among the three groups （P<0.05）.Non-DPN group showed higher average level of serum ghrelin than other two groups （P<0.05）.The average serum ghrelin level of definite DPN group was decreased than that of subclinical DPN group （P<0.05）.Serum ghrelin decreased with the increase of diabetic duration，BMI and HOMA-IR by Pearson correlation analysis （all P<0.05）.Serum ghrelin was still negatively correlated with BMI and HOMA-IR （all P<0.05），but no longer correlated with diabetic duration （P>0.05） revealed by partial correlation analysis.Increased diabetic duration and HbA1c，as well as decreased serum ghrelin were independent risk factors for abnormal nerve conduction function，subclinical DPN and definite DPN in multivariate Logistic regression analysis （P<0.05）.Conclusion　Decreased serum ghrelin level is significantly associated with subclinical DPN and definite DPN in patients with type 2 diabetes，and is a risk factor for abnormal nerve conduction function，subclinical DPN and definite DPN.

Key words: Diabetes mellitus, type 2；Ghrelin；Peripheral nervous system diseases；Correlation analysis；Root cause analysis

摘要： 背景　胃饥饿素是机体的一种内源性胃肠肽激素，具有改善糖尿病神经损伤的作用，然而在人体与糖尿病周围神经病变（DPN）的相关研究甚少。在临床上随着DPN病情的发展，可表现为亚临床及临床症状明显的DPN，而胃饥饿素在DPN各个阶段发挥的作用尚不明确。目的　分析血清胃饥饿素水平与2型糖尿病患者不同阶段DPN的关系。方法　选取2017年7月—2018年12月于唐山市工人医院内分泌科就诊的2型糖尿病患者247例。依据《中国2型糖尿病防治指南（2017年版）》中DPN诊断标准将患者分为非DPN患者（N-DPN组）129例、亚临床DPN患者（S-DPN组）57例和确诊的DPN患者（D-DPN组）61例。比较3组患者血清胃饥饿素水平，采用Pearson相关分析、Spearman秩相关分析及偏相关分析血清胃饥饿素水平与患者临床资料的关系，采用多因素Logistic回归分析探讨2型糖尿病患者神经传导功能异常以及S-DPN、D-DPN影响因素。结果　3组患者胃饥饿素水平比较，差异有统计学意义（P<0.05）；S-DPN组及D-DPN组胃饥饿素水平较N-DPN组降低，D-DPN组血清胃饥饿素水平较S-DPN组降低（P<0.05）；Pearson相关分析表明，血清胃饥饿素水平与糖尿病病程、BMI及胰岛素抵抗指数（HOMA-IR）呈负相关（P<0.05）；在偏相关分析中血清胃饥饿素水平仍与BMI、HOMA-IR呈负相关（P<0.05），与糖尿病病程无相关关系（P>0.05）。多因素Logistic回归分析显示，糖尿病病程长、糖化血红蛋白（HbA1c）水平高及血清胃饥饿素水平低为糖尿病神经传导功能异常、S-DPN及D-DPN的危险因素（P<0.05）。结论　血清胃饥饿素水平低与2型糖尿病患者的S-DPN及D-DPN均密切相关，是糖尿病神经传导功能异常、S-DPN及D-DPN的危险因素。

关键词: 糖尿病, 2型；胃饥饿素；周围神经系统疾病；相关性分析；影响因素分析

TIAN Luobing,XU Gang,ZHANG Yazhong, et al. Association of Serum Ghrelin Level with Type 2 Diabetic Peripheral Neuropathy　[J]. Chinese General Practice, 2020, 23(26): 3263-3267. DOI: 10.12114/j.issn.1007-9572.2020.00.424.
田骆冰,徐刚,张雅中等. 血清胃饥饿素水平与2型糖尿病周围神经病变的相关性研究[J]. 中国全科医学, 2020, 23(26): 3263-3267. DOI: 10.12114/j.issn.1007-9572.2020.00.424.

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