血清纤维蛋白胶凝素-3水平与2型糖尿病并发周围神经病变关系的研究

曹洁琼; 裴晓艳; 胡红艳; 金国玺

doi:10.16766/j.cnki.issn.1674-4152.002402

血清纤维蛋白胶凝素-3水平与2型糖尿病并发周围神经病变关系的研究

doi: 10.16766/j.cnki.issn.1674-4152.002402

蚌埠医学院第一附属医院内分泌科，安徽蚌埠 233004

基金项目:

安徽高校自然科学研究项目 KJ2019A0353

详细信息

通讯作者:
金国玺，E-mail：jyzjyz1999@163.com

中图分类号: R587.2 R392.11
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出版历程
- 收稿日期: 2021-10-15
- 网络出版日期: 2022-08-20

Function and significance of serum ficolin-3 level in type 2 diabetes mellitus with peripheral neuropathy

Department of Endocrinology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨人血清纤维蛋白胶凝素-3(ficolin-3)与2型糖尿病并发周围神经病变(DPN)的关系及意义。方法选取2020年10月—2021年5月在蚌埠医学院第一附属医院住院治疗的2型糖尿病患者88例，根据是否并发周围神经病变分为单纯2型糖尿病(T2DM组)38例，周围神经病变(DPN组)50例，另选取同期健康体检者30人作为对照组(NC组)。采用ELISA法检测3组血清ficolin-3水平，采用散射比浊法测定血清补体C3浓度, 采用常规方法检测一般生化指标。结果 DPN组ficolin-3、补体C3低于T2DM组和NC组[ficolin-3:(19.19±3.37)ng/mL、(25.53±4.17)ng/mL、(24.57±4.19)ng/mL；补体C3:(0.95±0.39)g/L、(1.27±0.52)g/L、(1.24±0.28)g/L, 均P < 0.05]。Pearson相关分析显示ficolin-3与补体C3呈正相关(r=0.223, P < 0.05)，与CRP、胰岛素抵抗指数呈负相关(r=-0.254、-0.774, 均P < 0.05)。多因素二元logistic回归分析结果显示ficolin-3(OR=0.686, 95% CI：0.541~0.870)、补体C3(OR=0.205, 95% CI：0.043~0.988)、糖尿病病程(OR=1.158, 95% CI：1.022~1.312)与DPN的发生独立相关(均P < 0.05)。结论 Ficolin-3可能通过激活补体途径、加重炎症反应和胰岛素抵抗参与DPN的发生。
- 糖尿病周围神经病变 /
- 血清纤维蛋白胶凝素-3 /
- 补体C3
Abstract: Objective To explore the relationship and significance of serum ficolin-3 level in type 2 diabetic peripheral neuropathy (DPN). Methods Eighty-eight T2DM patients who were hospitalised in the First Affiliated Hospital of Bengbu Medical College from October 2020 to May 2021 were selected and divided into the T2DM group (38 cases) and DPN group (50 cases) according to whether they were complicated with diabetic peripheral neuropathy. Another 30 healthy subjects were selected as the control group (NC group). Serum ficolin-3 levels were detected by enzyme-linked immunosorbent assay. Serum complement C3 concentration was determined by scattering turbidimetric method. The general biochemical indexes were detected by conventional methods. Results Ficolin-3 and C3 levels in the DPN group were lower than those in the T2DM and NC groups [ficolin-3: (19.19±3.37) ng/mL, (25.53±4.17) ng/mL, (24.57±4.19) ng/mL; C3: (0.95±0.39) g/L, (1.27±0.52) g/L, (1.24±0.28) g/L, all P < 0.05]. Pearson correlation analysis showed that ficolin-3 was positively correlated with C3 (r=0.223, P < 0.05) and negatively correlated with CRP and HOMA-IR (r=-0.254, -0.774, all P < 0.05). Binary logistic multifactor regression analysis showed that ficolin-3 levels (OR=0.686, 95% CI: 0.541-0.870), C3 levels (OR=0.205, 95% CI: 0.043-0.988) and the duration of diabetes (OR=1.158, 95% CI: 1.022-1.312) were independently correlated with DPN (P < 0.05). Conclusion Ficolin-3 may be involved in DPN by activating the complement pathway, aggravating inflammatory response and insulin resistance.
- Diabetic peripheral neuropathy /
- Ficolin-3 /
- Complement C3

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表 1 3组研究对象一般资料及各项指标比较

Table 1. Comparison of general data and various indicators of the three groups of subjects

组别	例数	性别 (男/女，例)	年龄 (x±s，岁)	病程 [M(P₂₅, P₇₅)，年]	HbA1c (x±s，%)	C3 (x±s，g/L)	SBP (x±s，mm Hg)	DBP (x±s，mm Hg)
NC组	30	17/13	54.67±10.70		5.30±0.43	1.24±0.28	125.23±13.10	77.53±8.49
T2DM组	38	18/20	55.47±13.17	7(1, 11)	8.25±1.15^d	1.27±0.52	140.63±15.91^d	84.61±15.02^d
DPN组	50	30/20	60.42±11.47	11(5, 19)	9.05±1.67^de	0.95±0.39^de	138.84±17.49^d	83.00±11.05
统计量		1.433^a	2.917^b	-3.225^c	82.426^b	7.881^b	9.207^b	3.169^b
P值		0.488	0.058	0.001	< 0.001	0.001	< 0.001	0.046

组别	例数	CRP [M(P₂₅, P₇₅)，mg/L]	BMI (x±s)	FPG (x±s，mmol/L)	UA (x±s，μmol/L)	Scr (x±s，μmol/L)	TG[M(P₂₅，P₇₅)，mmol/L]	HOMA-IR [M(P₂₅, P₇₅)]
NC组	30	1.24(0.68, 2.10)	23.63±3.69	4.86±0.53	283.80±88.10	61.73±11.35	1.20(0.81, 1.56)	1.97(1.53, 2.14)
T2DM组	38	1.40(0.60, 3.28)	26.07±3.30^d	9.39±3.57^d	271.32±75.54	58.16±12.28	1.58(1.09, 2.04)^d	3.30(2.69, 3.64)^d
DPN组	50	2.15(1.20, 4.54)^de	25.61±3.84^d	8.22±3.21^d	266.22±75.25	60.40±13.05	1.41(1.03, 1.93)	3.87(3.23, 4.10)^de
统计量		15.439^a	4.196^b	21.217^b	0.479^b	0.739^b	6.697^a	74.585^a
P值		< 0.001	0.017	< 0.001	0.621	0.480	0.035	< 0.001

组别	例数	AST [M(P₂₅, P₇₅)，U/L]	ficolin-3 (x±s，ng/mL)	LDL-C (x±s，mmol/L)	FIns [M(P₂₅, P₇₅)，mU/L]	HDL-C (x±s，mmol/L)	TC (x±s，mmol/L)	ALT [M(P₂₅, P₇₅)，U/L]
NC组	30	19(18.00, 21.25)	24.57±4.19	2.46±0.60	8.85(6.82, 10.48)	1.00±0.24	4.41±0.81	15.0(13.00, 20.50)
T2DM组	38	20(18.00, 24.25)	25.53±4.17^d	2.66±0.97	8.53(6.34, 9.52)	1.07±0.31	4.54±1.37	17.5(13.75, 31.75)
DPN组	50	20(17.75, 24.25)	19.19±3.37^de	2.60±0.93	11.06(8.08, 14.49)^de	0.95±0.16	4.32±1.13	17.0(13.75, 22.25)
统计量		1.183^a	34.419^b	0.445^b	19.538^a	2.905^b	0.382^b	3.818^a
P值		0.554	< 0.001	0.642	< 0.001	0.059	0.683	0.148
注：^a为χ²值, ^b为F值, ^c为Z值；与同项目对照组比较，^dP < 0.05；与同项目T2DM组比较，^eP < 0.05。1 mm Hg=0.133 kPa。

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表 2 ficolin-3与相关指标的Pearson相关分析

Table 2. Pearson correlation analysis of ficolin-3 and related indicators

统计量	病程	HbA1c	CRP	HOMA-IR	补体C3
r值	-0.198	-0.165	-0.254	-0.774	0.223
P值	0.065	0.125	0.017	＜0.001	0.037

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表 3 DPN影响因素的多因素二元logistic回归分析

Table 3. Multivariate binary logistic regression analysis of influencing factors of DPN

项目	B	SE	Wald χ²	P值	OR值	95% CI
HbA1c	0.361	0.253	2.046	0.153	1.435	0.875~2.355
病程	0.147	0.064	5.312	0.021	1.158	1.022~1.312
ficolin-3	-0.377	0.121	9.668	0.002	0.686	0.541~0.870
CRP	0.323	0.207	2.440	0.118	1.382	0.921~2.073
补体C3	-1.585	0.802	3.899	0.048	0.205	0.043~0.988
HOMA-IR	0.559	1.017	0.302	0.582	1.749	0.238~12.827
FIns	0.123	0.081	2.313	0.128	1.130	0.965~1.324

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