Department of Endocrinology, Jiangsu Rudong County People's Hospital, Jiangsu Province, PR China.
Department of Endocrinology, Affiliated Hospital 2 of Nantong University, and First People's Hospital of Nantong, Jiangsu Province, PR China.
Clinics (Sao Paulo). 2024 Jun 21;79:100392. doi: 10.1016/j.clinsp.2024.100392. eCollection 2024.
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.
本研究旨在探讨 2 型糖尿病（T2DM）患者血浆胰高血糖素水平反映的胰岛α细胞功能与糖尿病周围神经病变（DPN）之间的相关性。
回顾性纳入 358 例 T2DM 患者，分为非 DPN（NDPN）组（n=220）和 DPN 组（n=138）。所有患者行口服葡萄糖耐量试验检测血糖、胰岛素和胰高血糖素水平，采用胰高血糖素曲线下面积（AUCglu）评估总体胰高血糖素水平。应用肌电图检测周围神经传导速度（PNCV）、波幅（PNCA）和潜伏期（PNCL），并计算其 Z 评分。
两组间年龄、病程、血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、尿素氮、高密度脂蛋白及 2h-C 肽水平比较差异均有统计学意义（p<0.05）。NDPN 组胰高血糖素在 30、60、120min 及 AUCglu 水平均较高（p<0.05）。PNCV 及 PNCA 的 Z 评分呈升高趋势（p<0.05），而 PNCL 的 Z 评分呈下降趋势（p<0.05）。胰高血糖素水平与 PNCV 和 PNCA 呈正相关，与 PNCL 呈负相关，其中 Gluca30min 相关性最强（p<0.05）。Gluca30min 与 PNCV、PNCL、PNCA 及 DPN 均独立相关（p<0.05）。
血浆胰高血糖素水平反映的胰岛α细胞功能与 T2DM 患者 DPN 的发生密切相关。
注：文中的下划线为原文和译文不一致的地方，仅供参考。
