河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (8): 953-958.doi: 10.3969/j.issn.1007-3205.2025.08.014

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血浆致动脉硬化指数联合血尿酸/高密度脂蛋白胆固醇比值预测2型糖尿病发生早期DPN的价值分析

  

  1. 1.河北中医药大学研究生院，河北 石家庄 050011；2.河北省中医院内分泌科，河北 石家庄 050011

  • 出版日期:2025-08-25 发布日期:2025-08-29
  • 作者简介:甄云蕾（1999-），女，河北石家庄人，河北中医药大学第一附属医院医 学硕士研究生，从事内分泌疾病的中西医结合治疗研究。

  • 基金资助:
    河北省政府资助临床医学优秀人才培养项目（ZF2023169）

Analysis of the value of atherogenic index of plasma combined with blood uric acid/high-density lipoprotein cholesterol ratio in predicting the development of early DPN in patients with type 2 diabetes mellitus

  1. 1.Department of Graduate School,Hebei University of Chinese Medicine, Shijiazhuang 050011, China; 
    2.Department of Endocrinology, Hebei Provincial Hospital of Traditional Chinese Medicine, 
    Shijiazhuang 050011, China

  • Online:2025-08-25 Published:2025-08-29

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摘要： 目的 探究血浆致动脉硬化指数（atherogenic index of plasma, AIP）联合血尿酸/高密度脂蛋白胆固醇比值（blood uric acid/high-density lipoproteincholesterol ratio,UHR）对2型糖尿病（type 2 diabetes,T2DM）发生早期糖尿病周围神经病变（diabetic peripheral neuropathy,DPN）的预测价值。
方法 选取2022年8月—2023年8月于河北省中医院内分泌科门诊疑似为DPN患者314例，入院后行神经电生理检查，根据检查结果，最终确诊DPN患者173例（DPN组），其余未确诊DPN的患者为141例（NDPN组）。收集患者的一般临床资料及神经传导速度，计算AIP、UHR值。Spearman相关性分析AIP、UHR与神经传导速度的相关性；Logistic回归分析DPN的影响因素；绘制AIP、UHR及两者联合预测早期DPN发生的受试者工作特征（receiver operating characteristic,ROC）曲线，评估预测效能。
结果 2组性别、年龄及糖尿病病程比较，差异无统计学意义（P＞0.05），DPN组空腹血糖（fasting blood sugar,FBG）、糖化血红蛋白（glycosylated hemoglobin,HbA1c）、总胆固醇（total cholesterol,TC）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）较NDPN组未见明显升高，差异无统计学意义（P＞0.05），2组神经传导速度及三酰甘油（triacylglycerol,TG）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、血尿酸（serum uric acid,SUA）、AIP、UHR比较，差异有统计学意义（P＜0.05）；Spearman相关性分析显示，AIP、UHR与神经传导速度呈负相关（P＜0.05）；Logistic回归分析结果显示，年龄（OR=1.038，95%CI：1.013~1.064）、病程（OR=1.122，95%CI：1.012~1.244）、AIP（OR=1.680，95%CI：1.384~2.039）、UHR（OR=1.006，95%CI：1.003~1.008）是DPN的独立危险因素（P＜0.05）；ROC曲线分析结果显示，AIP、UHR及两者联合预测早期DPN的曲线下面积（area under curve,AUC）分别为0.731（95%CI：0.676~0.785）、0.727（95%CI：0.671~0.783）、0.774（95%CI：0.722~0.826），截断值分别为2.25、337.36、0.56，敏感度分别为63.6%、65.3%、70.5%，特异度分别为74.5%、72.3%、75.9%。
结论 AIP与UHR均是诱发早期DPN的独立危险因素，相较于单一指标，两者联合应用预测早期DPN具有更高的价值。


关键词: 动脉粥样硬化, 糖尿病神经病变, 血尿酸, 高密度脂蛋白胆固醇

Abstract: Objective To investigate the predictive value of atherogenic index of plasma (AIP) combined with blood uric acid/high-density lipoprotein cholesterol ratio (UHR) in the development of early diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). 
Methods In total,314 patients with suspected DPN were selected from the Outpatient Department of Endocrinology, Hebei Provincial Hospital of Traditional Chinese Medicine from August 2022 to August 2023, and underwent neurophysiological examination after admission to the hospital. According to the results of the examination, 173 patients were finally diagnosed with DPN (DPN group), and the remaining 141 patients who were not diagnosed with DPN were assigned to the NDPN group. The general clinical data and nerve conduction velocity of the patients were collected, and the values of AIP and UHR were calculated. Spearman correlation analysis was performed to analyze the correlation between AIP, UHR and nerve conduction velocity, and logistic regression analysis was performed to analyze the influencing factors of DPN. The receiver operating characteristic (ROC) of AIP and UHR alone and in combination was plotted to predict the occurrence of early DPN, and the predictive efficacy was evaluated. 
Results Comparison of gender, age and duration of diabetes mellitus between the two groups showed no significant difference (P＞0.05). Fasting blood glucose, glycosylated hemoglobin, total cholesterol, and low-density lipoprotein cholesterol  were not significantly elevated in the DPN group compared with the NDPN group, showing no significant difference (P＞0.05), while nerve conduction velocity, triacylglycerol, high-density lipoprotein cholesterol,serum uric acid, AIP, and UHRshowed significant difference (P＜0.05). Spearman correlation analysis showed that AIP and UHRwere negatively correlated with nerve conduction velocity (P＜0.05). Logistic regression analysis showed that age (OR=1.038, 95%CI: 1.013-1.064), duration of disease (OR=1.122,95%CI: 1.012-1.244), AIP (OR=1.680,95%CI: 1.384-2.039), and UHR (OR=1.006,95%CI: 1.003-1.008) were independent risk factors for DPN (P＜0.05). The results of ROC curve analysis showed that the area under curve (AUC) of AIP and UHR alone and in combination for predicting early DPN was 0.731 (95%CI: 0.676-0.785), 0.727 (95%CI: 0.671-0.783), 0.774 (95%CI: 0.722-0.826), respectively, with cut-off values of 2.25, 337.36, and 0.56, respectively, sensitivity of 63.6%, 65.3%, and 70.5%, and specificity of 74.5%, 72.3%, and 75.9%, respectively. 
Conclusion Both AIP and UHR are independent risk factors for inducing early DPN, and the combined application of the two has a higher value in predicting early DPN compared with a single indicator. 


Key words: atherosclerosis, diabetic neuropathies, serum uric acid, high-density lipoprotein cholesterol

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