Department of Endocrinology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.
The Third School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
J Diabetes Investig. 2024 Sep;15(9):1259-1265. doi: 10.1111/jdi.14260. Epub 2024 Jun 24.
AIMS/INTRODUCTION: To investigate risk factors for diabetic peripheral neuropathy (DPN) and to explore the connection between insulin-like growth factor-1 (IGF-1) and DPN in individuals with type 2 diabetes.
A total of 790 patients with type 2 diabetes participated in a cross-sectional study, divided into two groups: those with DPN (DPN) and those without DPN (non-DPN). Blood samples were taken to measure IGF-1 levels and other biochemical markers. Participants underwent nerve conduction studies and quantitative sensory testing.
Patients with DPN exhibited significantly lower levels of IGF-1 compared with non-DPN patients (P < 0.001). IGF-1 was positively correlated with the average amplitude of both motor (P < 0.05) and sensory nerves (P < 0.05), but negatively correlated with the vibration perception threshold (P < 0.05). No significant difference was observed between IGF-1 and nerve conduction velocity (P > 0.05), or the temperature detection threshold (P > 0.05). Multivariate regression analysis identified diabetes duration, HbA, and the low levels of IGF-1 as independent risk factors (P < 0.001). Receiver operating characteristic analysis determined that at 8 years duration of diabetes, 8.5% (69.4 mmol/mol) HbA and 120 ng/mL IGF-1, the optimal cut-off points, indicated DPN (P < 0.001).
A reduction of IGF-1 in patients with DPN suggests a potential protective role against axon injury in large fiber nerves of type 2 diabetes patients.
目的/引言:研究糖尿病周围神经病变(DPN)的危险因素,并探讨 2 型糖尿病患者中胰岛素样生长因子-1(IGF-1)与 DPN 的关系。
共纳入 790 例 2 型糖尿病患者进行横断面研究,分为有 DPN(DPN)和无 DPN(非 DPN)两组。采集血样以测量 IGF-1 水平和其他生化标志物。参与者接受神经传导研究和定量感觉测试。
DPN 患者的 IGF-1 水平明显低于非 DPN 患者(P<0.001)。IGF-1 与运动(P<0.05)和感觉神经的平均幅度呈正相关,但与振动感觉阈值呈负相关(P<0.05)。IGF-1 与神经传导速度(P>0.05)或温度检测阈值(P>0.05)之间无显著差异。多变量回归分析确定糖尿病病程、HbA 和 IGF-1 水平低是独立的危险因素(P<0.001)。受试者工作特征分析确定在糖尿病病程 8 年、HbA 为 8.5%(69.4mmol/mol)和 IGF-1 为 120ng/mL 时,最佳截断点提示 DPN(P<0.001)。
DPN 患者 IGF-1 降低提示 IGF-1 可能对 2 型糖尿病患者大纤维神经轴突损伤具有潜在的保护作用。