Rathod Mitali B, Teja Reddy Anuka, Nagaraju Bhavya, Jr Chanthu, Arumugaperumal Dheepika, Ashwini Maria Sneha
General Medicine, NAMO Medical College and Research Centre, Silvassa, IND.
Department of General Medicine, International School of Medicine, Bishkek, KGZ.
Cureus. 2024 Dec 2;16(12):e74977. doi: 10.7759/cureus.74977. eCollection 2024 Dec.
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that imposes significant complications, including diabetic peripheral neuropathy (DPN). DPN is characterized by marked inflammation, and the fibrinogen-to-albumin ratio (FAR) is one of the new markers for systemic inflammation, it has been used in various diabetic micro- and macro-vascular complications. The present study investigates the association between FAR and nerve conduction abnormalities in T2DM patients with DPN.
This was a cross-sectional study conducted on 200 T2DM patients, and 110 (55%) were diagnosed with DPN. Patients were divided into DPN and non-DPN groups. The patient's demographics and the biochemical variables fibrinogen, albumin, and FAR were evaluated and compared among the DPN and non-DPN groups. Nerve conduction studies (NCS) were performed to evaluate motor and sensory nerve functions. Patients were further stratified into FAR tertiles (low, moderate, and high FAR) for subgroup analysis.
The fibrinogen levels were significantly higher (375.65 ± 35.43 mg/dL vs. 342.87 ± 42.12 mg/dL; p<0.001) and albumin levels were lower (3.12 ± 0.41 g/dL vs. 4.07 ± 0.57 g/dL; p<0.001) in DPN as compared to non-DPN patients. Meanwhile, FAR was higher in DPN as compared to non-DPN patients (120.40 ± 26.32 vs. 84.24 ± 12.87; p<0.001). Further, there was a significant negative correlation for conduction velocities and amplitudes and a positive correlation for latencies with FAR across all nerves tested (p<0.05). In addition, high FAR tertile patients showed lower conduction velocities (peroneal nerve: 35.26 ± 5.82 m/s vs. 42.53 ± 5.34 m/s; p<0.001), reduced amplitudes, and prolonged latencies when compared to moderate and low FAR tertile patients (p<0.05).
Nerve conduction abnormalities in T2DM patients with DPN showed significant association with FAR. Thus, FAR serves as a simple and effective biochemical marker for the assessment of DPN severity.
2型糖尿病（T2DM）是一种慢性代谢紊乱疾病，会引发包括糖尿病性周围神经病变（DPN）在内的严重并发症。DPN的特征是显著炎症，纤维蛋白原与白蛋白比值（FAR）是全身炎症的新标志物之一，已用于各种糖尿病微血管和大血管并发症。本研究调查了FAR与DPN的T2DM患者神经传导异常之间的关联。
这是一项对200例T2DM患者进行的横断面研究，其中110例（55%）被诊断为DPN。患者被分为DPN组和非DPN组。评估并比较了DPN组和非DPN组患者的人口统计学特征以及纤维蛋白原、白蛋白和FAR等生化变量。进行神经传导研究（NCS）以评估运动和感觉神经功能。患者进一步分为FAR三分位数（低、中、高FAR）进行亚组分析。
与非DPN患者相比，DPN患者的纤维蛋白原水平显著更高（375.65±35.43mg/dL对342.87±42.12mg/dL；p<0.001），白蛋白水平更低（3.12±0.41g/dL对4.07±0.57g/dL；p<0.001）。同时，与非DPN患者相比，DPN患者的FAR更高（120.40±26.32对84.24±12.87；p<0.001）。此外，在所有测试神经中，传导速度和波幅与FAR呈显著负相关，潜伏期与FAR呈正相关（p<0.05）。此外，与中、低FAR三分位数患者相比，高FAR三分位数患者的传导速度更低（腓总神经：35.26±5.82m/s对42.53±5.34m/s；p<0.001），波幅降低，潜伏期延长（p<0.05）。
DPN的T2DM患者的神经传导异常与FAR显著相关。因此，FAR可作为评估DPN严重程度的简单有效生化标志物。
