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血清白蛋白与2型糖尿病患者的周围神经功能有关。

Serum albumin is associated with peripheral nerve function in patients with type 2 diabetes.

作者信息

Li Lu, Liu Bo, Lu Jingyi, Jiang Lan, Zhang Yinan, Shen Yingdi, Wang Congrong, Jia Weiping

机构信息

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, 600 Yishan Road, Shanghai, 200233, People's Republic of China.

Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Jinshan Branch, Shanghai, People's Republic of China.

出版信息

Endocrine. 2015 Nov;50(2):397-404. doi: 10.1007/s12020-015-0588-8. Epub 2015 Apr 10.

Abstract

The aim of this study is to investigate the association between serum albumin concentrations and nerve conduction (NC) parameters in Chinese patients with type 2 diabetes (T2DM). A total of 409 T2DM patients were enrolled between October 2010 and April 2014. All participants underwent nerve conduction studies. The composite Z scores for NC parameters including conduction velocity (CV), amplitude, and latency were calculated as well. Serum albumin was measured by Bromcresol Green dye-binding method. The composite Z scores of CV and amplitude increased with the increasing albumin tertiles (test for trend, both P < 0.001), while the composite Z score of latency decreased with increasing albumin tertiles (test for trend, P < 0.001). After adjusting for age, sex, duration, and HbA1c, higher serum albumin concentrations were associated with higher composite Z scores of CV (β = 0.314, P < 0.001), amplitude (β = 0.279, P < 0.001), and lower composite Z score of latency (β = -0.279, P < 0.001). When participants were stratified into albuminuria and normoalbuminuria group, we found the associations of serum albumin with composite Z scores of NC parameters remained significant only in the albuminuria group (CV Z score: β = 0.253, P = 0.002; amplitude Z score: β = 0.233, P = 0.006; latency Z score: β = -0.217 P = 0.013) after further adjustment for urinary albumin to creatinine ratio. The optimal cutoff point of serum albumin to indicate abnormal peripheral nerve function was 36.75 g/L in T2DM patients with albuminuria, with a sensitivity of 65.6 % and a specificity of 78.0 %. Serum albumin was independently associated with peripheral nerve function in T2DM patients, especially in those with albuminuria. Serum albumin could be a potential biomarker for diabetic peripheral neuropathy.

摘要

本研究旨在探讨中国2型糖尿病(T2DM)患者血清白蛋白浓度与神经传导(NC)参数之间的关联。2010年10月至2014年4月期间共纳入409例T2DM患者。所有参与者均接受神经传导研究。还计算了包括传导速度(CV)、波幅和潜伏期在内的NC参数的综合Z评分。血清白蛋白采用溴甲酚绿染料结合法测定。CV和波幅的综合Z评分随白蛋白三分位数的增加而升高(趋势检验,P均<0.001),而潜伏期的综合Z评分随白蛋白三分位数的增加而降低(趋势检验,P<0.001)。在调整年龄、性别、病程和糖化血红蛋白后,较高的血清白蛋白浓度与较高的CV综合Z评分(β=0.314,P<0.001)、波幅(β=0.279,P<0.001)以及较低的潜伏期综合Z评分(β=-0.279,P<0.001)相关。当参与者被分为蛋白尿组和正常白蛋白尿组时,我们发现,在进一步调整尿白蛋白与肌酐比值后,血清白蛋白与NC参数综合Z评分之间的关联仅在蛋白尿组中仍然显著(CV Z评分:β=0.253,P=0.002;波幅Z评分:β=0.233,P=0.006;潜伏期Z评分:β=-0.217,P=0.013)。在有蛋白尿的T2DM患者中,提示外周神经功能异常的血清白蛋白最佳截断点为36.75g/L,敏感性为65.6%,特异性为78.0%。血清白蛋白与T2DM患者的外周神经功能独立相关,尤其是在有蛋白尿的患者中。血清白蛋白可能是糖尿病周围神经病变的一个潜在生物标志物。

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