河北医科大学学报 ›› 2024, Vol. 44 ›› Issue (5): 580-584.doi: 10.3969/j.issn.1007-3205.2024.05.015

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2型糖尿病伴泌汗神经功能紊乱患者胰岛素分泌和血清25(OH)D3、NLR、SUA水平及临床意义分析

  

  1. 江苏省海安市人民医院内分泌科，江苏 海安 2266000

  • 出版日期:2024-05-25 发布日期:2024-05-22
  • 作者简介:席巍（1981-），男，江苏海安人，江苏省海安市人民医院副主任医师，医学硕士研究生，从事内分泌疾病诊治研究。
  • 基金资助:
    南通市科技局项目（MSZ2022057）；江苏省卫生健康委科研立项（Z2019033）

Analysis of insulin secretion, serum 25 (OH) D3, NLR, SUA levels and their clinical significance in type 2 diabetes patients with dyshidrotic nerve function

  1. Department of Endocrinology, Hai′an People′s Hospital, Jiangsu Province, Hai′an 2266000, China

  • Online:2024-05-25 Published:2024-05-22

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摘要： 目的 探讨2型糖尿病伴泌汗神经功能紊乱患者胰岛素分泌和血清25羟维生素D3［25 hydroxyvitamin D3,25(OH)D3］、中性粒细胞与淋巴细胞比值（neutrophil to lymphocyte ratio，NLR）、血尿酸（serum uric acid，SUA）水平变化及临床意义。
方法 选取在我院治疗的2型糖尿病伴泌汗神经功能紊乱患者97例作为观察组，以性别配比1〖DK〗∶2选取2型糖尿病不伴泌汗神经功能紊乱患者194例作为对照组，分析比较2组临床资料、胰岛功能及25(OH)D3、NLR和SUA水平差异，通过Logistic回归分析分析2型糖尿病伴泌汗神经功能紊乱的影响因素。
结果 观察组年龄、糖尿病病程分别为（58.32±9.94）岁和（11.41±2.84）年，明显高于对照组（P＜0.05）；观察组糖负荷30 min净增C肽与葡萄糖比值（ΔC-P30/ΔG30）、净增胰岛素与葡萄糖比值（ΔI30/ΔG30）、胰岛素曲线下面积（I-AUC/G-AUC）和120 min血糖曲线下面积校正后的C肽（C-P-AUC/G-AUC）分别为（0.22±0.13）、（1.55±0.36）、（0.09±0.03）和（2.87±0.90），明显低于对照组（P＜0.05）。观察组血清25(OH)D3为（22.12±6.01） μg/L，〖JP2〗明显低于对照组（P＜0.05），而NLR和SUA分别为（3.12±0.94）和（365.50±90.48） μmol/L，〖JP〗明显高于对照组（P＜0.05）。Logistic回归分析显示：年龄、糖尿病病程、ΔC-P30/ΔG30、25(OH)D3、NLR和SUA是2型糖尿病伴泌汗神经功能紊乱的影响因素（P＜0.05）。
结论 2型糖尿病伴泌汗神经功能紊乱患者胰岛素分泌功能受损，血清25(OH)D3降低，而NLR和SUA水平升高；2型糖尿病伴泌汗神经功能紊乱受早期相胰岛分泌功能以及血清25(OH)D3、NLR、SUA水平的影响，值得进一步研究。


关键词: 糖尿病, 2型, 胰岛素分泌, 泌汗神经功能紊乱

Abstract: Objective To investigate the insulin secretion, serum 25 hydroxyvitamin D3 ［25 (OH) D3］, neutrophil to lymphocyte ratio (NLR), serum uric acid (SUA) levels and clinical significance in patients with type 2 diabetes mellitus (T2DM) accompanied by sudomotor dysfunction.〖KG*2〗
Methods In total, 97 patients with T2DM and sudomotor dysfunction treated in our hospital were selected as the observation group, and 194 patients with T2DM but without sweating nerve dysfunction were selected as the control group with a gender ratio of 1〖DK〗∶2. The differences in clinical data, islet function, 25 (OH) D3, NLR and SUA levels between the two groups were analyzed and compared. The factors affecting T2DM combined with sudomotor dysfunction were analyzed by Logistic regression analysis. 
Results The age and duration of diabetes in the observation group were (58.32±9.94) years and (11.41±2.84) years respectively, which were significantly higher than those in the control group (P＜0.05). The ratio of net increase in C-peptide to glucose (ΔC-P30/ΔG30), the ratio of net increase in insulin to glucose (ΔI30/ΔG30), the area under the curve of insulin (I-AUC/G-AUC) and the AUC of corrected C-peptide under 120 min blood glucose (C-P-AUC/G-AUC) in the observation group were (0.22±0.13), (1.55±0.36), (0.09±0.03) and (2.87±0.90), respectively, which were significantly lower than those in the control group (P＜0.05). The serum 25 (OH) D3 in the observation group was (22.12 ± 6.01) μg/L, which was significantly lower than that in the control group (P＜0.05), while the NLR and SUA were (3.12±0.94) and (365.50±90.48) μmol/L, respectively, which were significantly higher than those in the control group (P＜0.05). Logistic regression analysis showed that age, course of diabetes, ΔC-P30/ΔG30, 25 (OH) D3, NLR and SUA were the influencing factors for the sudomotor dysfunction (P＜0.05). 
Conclusion Patients with T2DM and sudomotor dysfunction have impaired insulin secretion, decreased serum 25 (OH) D3, and increased NLR and SUA levels. T2DM combined with sudomotor dysfunction is affected by early phase pancreatic secretion function and serum 25 (OH) D3, NLR, and SUA levels, which warrants further studies.


Key words: diabetes mellitus, type 2, insulin secretion, sudomotor dysfunction

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