血浆 D-二聚体水平升高可能是 2 型糖尿病糖尿病周围神经病变有前途的指标。
Increased plasma D-dimer levels may be a promising indicator for diabetic peripheral neuropathy in type 2 diabetes.
机构信息
Department of Endocrinology, Second People's Hospital of Nantong City, Nantong, China.
Department of Clinical Laboratory, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong City, Nantong, China.
出版信息
Front Endocrinol (Lausanne). 2022 Aug 23;13:930271. doi: 10.3389/fendo.2022.930271. eCollection 2022.
BACKGROUND
Increased plasma D-dimer levels have been reported to be associated with a range of adverse health outcomes. This study aimed to determine whether plasma D-dimer is connected to diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes (T2D).
METHODS
This study was part of a series exploring the potential risks for DPN. All patients were questioned for neurologic symptoms, examined for neurologic signs, and received nerve conduction studies to collect nerve action potential onset latency, amplitude, and nerve conduction velocity (NCV). Composite scores of latency, amplitude, and NCV were calculated. DPN was confirmed as both at least a neurologic symptom/sign and an abnormality of nerve conduction studies. Coagulation function indices, such as plasma D-dimer levels, were also synchronously detected.
RESULTS
We finally recruited 393 eligible patients for this study, of whom 24.7% ( = 97) were determined to have DPN. The plasma D-dimer level was found to be closely associated with the composite score of latency, amplitude, and NCV after adjusting for other coagulation function indices and clinical covariates (latency: = 0.134, = 2.299, = 0.022; amplitude: = -0.138, = -2.286, = 0.023; NCV: = -0.139, = -2.433, = 0.016). Moreover, the prevalence of DPN in the first, second, third, and fourth quartiles (Q1, Q2, Q3, and Q4) of the D-dimer level was 15.2%, 15.9%, 26.4%, and 42.7%, respectively ( for trend < 0.001). The corresponding adjusted odds ratios and 95% CIs for DPN in D-dimer quartiles were 1, 0.79 (0.21-2.99), 1.75 (0.49-6.26), and 5.17 (1.38-19.42), respectively. Furthermore, the optimal cutoff value of the plasma D-dimer level to discriminate DPN was ≥0.22 mg/L (sensitivity = 67.01%, specificity = 58.78%, and Youden index = 0.26) after analysis by the receiver operating characteristic curve.
CONCLUSIONS
Increased plasma D-dimer levels may be a promising indicator for DPN in patients with T2D.
背景
已有研究报道，血浆 D-二聚体水平升高与多种不良健康结局相关。本研究旨在探讨 2 型糖尿病（T2D）患者的血浆 D-二聚体水平与糖尿病周围神经病变（DPN）之间的关系。
方法
本研究是一项旨在探索 DPN 潜在风险的研究的一部分。所有患者均接受了神经症状询问、神经体征检查和神经传导研究，以采集神经动作电位起始潜伏期、振幅和神经传导速度（NCV）。计算潜伏期、振幅和 NCV 的综合评分。DPN 被定义为至少存在神经症状/体征和神经传导研究异常。同时同步检测凝血功能指标，如血浆 D-二聚体水平。
结果
本研究最终纳入了 393 名符合条件的患者，其中 24.7%（97 名）被确定患有 DPN。调整其他凝血功能指标和临床协变量后，发现血浆 D-二聚体水平与潜伏期、振幅和 NCV 的综合评分密切相关（潜伏期： = 0.134， = 2.299， = 0.022；振幅： = -0.138， = -2.286， = 0.023；NCV： = -0.139， = -2.433， = 0.016）。此外，D-二聚体水平的第一、二、三、四分位数（Q1、Q2、Q3 和 Q4）的 DPN 患病率分别为 15.2%、15.9%、26.4%和 42.7%（趋势检验<0.001）。D-二聚体四分位数的 DPN 校正比值比和 95%CI 分别为 1、0.79（0.21-2.99）、1.75（0.49-6.26）和 5.17（1.38-19.42）。此外，通过受试者工作特征曲线分析，血浆 D-二聚体水平鉴别 DPN 的最佳截断值为≥0.22mg/L（灵敏度为 67.01%，特异性为 58.78%，约登指数为 0.26）。
结论
血浆 D-二聚体水平升高可能是 T2D 患者 DPN 的一个有前途的指标。
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