广西医学

目的　探讨血清铁蛋白、miR⁃122表达水平预测2型糖尿病（T2DM）患者并发糖尿病周围神经病变（DPN）的价值。方法　选取82例T2DM患者作为研究对象，根据常规治疗3个月后是否并发DPN分为并发组（并发DPN）和未并发组（未并发DPN）。比较两组患者临床资料（治疗前年龄、性别、体质指数、病程、收缩压、舒张压等）及实验室指标[治疗前白细胞计数、中性粒细胞计数、胰岛素抵抗的稳态模型评估（HOMA⁃IR），以及血清铁蛋白、甘油三酯、总胆固醇、HDL⁃C、LDL⁃C、HbA1c和miR⁃122表达水平]，采用二元Logistic逐步回归模型分析T2DM患者并发DPN的影响因素，绘制受试者工作特征（ROC）曲线评估影响因素预测T2DM患者并发DPN的效能。结果　82例T2DM患者有20例（24.39%）并发DPN。并发组血清甘油三酯、HbA1c、铁蛋白、miR⁃122表达水平高于未并发组（P<0.05）。二元Logistic回归分析结果显示，血清甘油三酯、HbA1c、铁蛋白、miR⁃122表达水平是T2DM患者并发DPN的影响因素（P<0.05）。ROC曲线分析结果显示，血清甘油三酯、铁蛋白、HbA1c、miR⁃122表达水平单独预测T2DM患者并发DPN的效能较好，曲线下面积分别为0.833、0.823、0.838、0.820（P<0.05），但四者联合预测的效能更佳，曲线下面积为0.945（P<0.05）。结论　与单纯T2DM患者相比，T2DM并发DPN患者的血清铁蛋白、miR⁃122表达水平升高，血清铁蛋白、miR⁃122表达水平单独预测T2DM并发DPN的效能较好，且二者联合血清甘油三酯、HbA1c可进一步提高预测效能。

Objective To explore the value of serum ferritin and miR⁃122 expressions for predicting patients with type 2 diabetes mellitus (T2DM) and concomitant diabetic peripheral neuropathy (DPN). Methods A total of 82 T2DM patients were selected as the research subjects, and they were assigned to concomitant group (concomitant DPN) or non⁃concomitant group (without concomitant DPN) according to the presence of concomitant DPN after 3⁃month routine therapy. The clinical data with respect to pre⁃treatment age, gender, body mass index, disease course, systolic blood pressure, and diastolic blood pressure, etc., laboratory indices in terms of pre⁃treatment white blood cell counts, neutrophil counts, homeostatic model assessment of insulin resistance (HOMA⁃IR), and expressions of serum ferritin, triglyceride, total cholesterol, HDL⁃C, LDL⁃C, HbA1c, and miR⁃122 were compared between patients of the two groups. The influencing factors for T2DM patients and concomitant DPN were analyzed by employing the binary Logistic stepwise regression model. The receiver operating characteristic (ROC) curve was drawn to evaluate the efficiency of the influencing factors for predicting T2DM patients and concomitant DPN. Results There were 20 cases (24.39%) concomitant DPN among 82 T2DM patients. The concomitant group exhibited higher expressions of serum triglyceride, HbA1c, ferritin, and miR⁃122 compared with the non⁃concomitant group (P<0.05). The results of binary Logistic regression analysis revealed that serum triglyceride, HbA1c, ferritin, and miR⁃122 expressions were the influencing factors for T2DM patients and concomitant DPN (P<0.05). The results of ROC curve analysis indicated that serum triglyceride, ferritin, HbA1c, and miR⁃122 expressions for alone predicting T2DM patients and concomitant DPN exerted a favorable efficiency, and areas under the curve were 0.833, 0.823, 0.838, and 0.820, respectively (P<0.05). However, the combination of the four indices exerted a superior predictive efficiency, with area under the curve of 0.945 (P<0.05). Conclusion Compared with single T2DM patients, T2DM patients and concomitant DPN obtain elevated serum ferritin and miR⁃122 expressions. Serum ferritin and miR⁃122 expressions alone have a good prediction efficiency for T2DM and concomitant DPN, and the combination of the two with serum triglyceride and HbA1c can further improve the prediction efficiency.