2型糖尿病患者血尿素氮水平升高及周围神经功能受损。

Increased blood urea nitrogen levels and compromised peripheral nerve function in patients with type 2 diabetes.

作者信息

Wang Rui, Xu Yu-Xian, Xu Feng, Wang Chun-Hua, Zhao Li-Hua, Wang Li-Hua, Chen Wei-Guan, Wang Xue-Qin, Duan Cheng-Wei, Su Jian-Bin

机构信息

Department of Endocrinology, The Affiliated Hospital 2 of Nantong University, Nantong First People's Hospital, Nantong 226001, Jiangsu Province, China.

Department of Nursing, The Affiliated Hospital 2 of Nantong University, Nantong First People's Hospital, Nantong 226001, Jiangsu Province, China.

出版信息

World J Diabetes. 2025 Apr 15;16(4):101966. doi: 10.4239/wjd.v16.i4.101966.

DOI:10.4239/wjd.v16.i4.101966

PMID:40236867

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11947929/

Abstract

BACKGROUND

Increased blood urea nitrogen (BUN) levels have been demonstrated to be associated with broader metabolic disturbances and the incidence of type 2 diabetes (T2D), potentially playing a role in the development of diabetic complications, including diabetic peripheral neuropathy.

AIM

To examine the relationship between BUN levels and peripheral nerve function in patients with T2D.

METHODS

This observational study involved the systematic recruitment of 585 patients with T2D for whom BUN levels and estimated glomerular filtration rate were measured. Electromyography was used to assess peripheral motor and sensory nerve function in all patients, and overall composite -scores were subsequently calculated for nerve latency, amplitude, and conduction velocity (NCV) across the median, ulnar, common peroneal, posterior tibial, superficial peroneal, and sural nerves.

RESULTS

Across the quartiles of BUN levels, the overall composite -score for latency ( = 38.996, for trend < 0.001) showed a significant increasing trend, whereas the overall composite -scores for amplitude ( = 50.972, for trend < 0.001) and NCV ( = 30.636, for trend < 0.001) exhibited a significant decreasing trend. Moreover, the BUN levels were closely correlated with the latency, amplitude, and NCV of each peripheral nerve. Furthermore, multivariate linear regression analysis revealed that elevated BUN levels were linked to a higher overall composite -score for latency (β = 0.166, = 3.864, < 0.001) and lower overall composite Z-scores for amplitude (β = -0.184, = -4.577, < 0.001) and NCV (β = -0.117, = -2.787, = 0.006) independent of the estimated glomerular filtration rate and other clinical covariates. Additionally, when the analysis was restricted to sensory or motor nerves, elevated BUN levels remained associated with sensory or motor peripheral nerve dysfunction.

CONCLUSION

Increased BUN levels were independently associated with compromised peripheral nerve function in patients with T2D.

摘要

背景

血液尿素氮（BUN）水平升高已被证明与更广泛的代谢紊乱及2型糖尿病（T2D）的发病率相关，可能在糖尿病并发症（包括糖尿病周围神经病变）的发生中起作用。

目的

研究T2D患者中BUN水平与周围神经功能之间的关系。

方法

这项观察性研究系统招募了585例T2D患者，测量其BUN水平和估计肾小球滤过率。所有患者均使用肌电图评估周围运动和感觉神经功能，随后计算正中神经、尺神经、腓总神经、胫后神经、腓浅神经和腓肠神经的神经潜伏期、波幅和传导速度（NCV）的总体综合评分。

结果

在BUN水平的四分位数范围内，潜伏期的总体综合评分（ = 38.996，趋势 < 0.001）呈显著上升趋势，而波幅（ = 50.972，趋势 < 0.001）和NCV（ = 30.636，趋势 < 0.001）的总体综合评分呈显著下降趋势。此外，BUN水平与各周围神经的潜伏期、波幅和NCV密切相关。此外，多变量线性回归分析显示，BUN水平升高与潜伏期的总体综合评分较高（β = 0.166， = 3.864， < 0.001）以及波幅（β = -0.184， = -4.577， < 0.001）和NCV（β = -0.117， = -2.787， = 0.006）的总体综合Z评分较低相关，且独立于估计肾小球滤过率和其他临床协变量。此外，当分析仅限于感觉或运动神经时，BUN水平升高仍与感觉或运动周围神经功能障碍相关。