背景:本研究探讨了胰岛α细胞功能与胰岛细胞功能,正如血浆胰高血糖素水平所反映的那样,2型糖尿病(T2DM)患者的糖尿病周围神经病变(DPN)。
方法:回顾性纳入358例T2DM患者,分为非DPN组(n=220)和DPN组(n=138)。所有患者均接受口服葡萄糖耐量试验以检测血糖水平,胰岛素和胰高血糖素,和胰高血糖素的曲线下面积(AUC)(AUCglu)用于估计总胰高血糖素水平。周围神经传导速度(PNCV),振幅(PNCA)和延迟(PNCL)通过肌电图获得,并计算了他们的Z分数。
结果:年龄存在显著差异,疾病持续时间,血清丙氨酸转氨酶水平,天冬氨酸转氨酶,尿素氮,高密度脂蛋白,和2h-C肽在这两组之间(p<0.05)。NDPN组在30、60和120分钟时具有较高的胰高血糖素水平和AUCglu(p<0.05)。PNCV和PNCA的Z得分呈增加趋势(p<0.05),PNCL的Z评分呈下降趋势(p<0.05)。胰高血糖素水平与PNCV、PNCA呈正相关,但与PNCL呈负相关,与Gluca30min的相关性最强(p<0.05)。Glucoa30min与PNCV独立相关,PNCL,PNCA和DPN,分别为(p<0.05)。胰岛α细胞的功能,正如血浆胰高血糖素水平所反映的那样,与T2DM患者DPN的发生密切相关。
结论:Glucoa30min可能是DPN发生的潜在有价值的独立预测因子。
This study explored the correlation between pancreatic islet α cell function, as reflected by the plasma
glucagon levels, and Diabetic Peripheral Neuropathy (DPN) in patients with Type 2 Diabetes Mellitus (T2DM).
A total of 358 patients with T2DM were retrospectively enrolled in this study and divided into the Non-DPN (NDPN) group (n = 220) and the DPN group (n = 138). All patients underwent an oral glucose tolerance test to detect levels of blood glucose, insulin and glucagon, and the Area Under the Curve (AUC) for
Glucagon (AUCglu) was used to estimate the overall
glucagon level. The Peripheral Nerve Conduction Velocity (PNCV), Amplitude (PNCA) and Latency (PNCL) were obtained with electromyography, and their Z scores were calculated.
There were significant differences regarding the age, disease duration, serum levels of alanine aminotransferase, aspartate aminotransferase, urea nitrogen, high-density lipoprotein, and 2h-C peptide between these two groups (p < 0.05). The NDPN group had higher
glucagon levels at 30, 60 and 120 min and AUCglu (p < 0.05). The Z-scores of PNCV and PNCA showed an increasing trend (p < 0.05), while the Z-score of PNCL showed a decreasing trend (p < 0.05). The
glucagon levels were positively correlated with PNCV and PNCA, but negatively correlated with PNCL, with Gluca30min having the strongest correlation (p < 0.05). Gluca30min was independently related to PNCV, PNCL, PNCA and DPN, respectively (p < 0.05). The function of pancreatic α islet cells, as reflected by the plasma
glucagon level, is closely related to the occurrence of DPN in T2DM patients.
Gluca30min may be a potentially valuable independent predictor for the occurrence of DPN.