Correlation analysis and risk factors of subclinical peripheral neuropathy and TIR in type 2 diabetes mellitus

doi:10.11958/20240569

Abstract

Abstract:

Objective To investigate the correlation between subclinical peripheral neuropathy (sDPN) and time in range (TIR) in type 2 diabetes mellitus (T2DM), and to explore the risk factors of sDPN. Methods A total of 485 T2DM patients without DPN symptoms and underwent EMG examination during hospitalization were divided into the sDPN group (n=209) and the non-sDPN group (n=276) according to nerve function conduction examination. The differences of age, course of the disease, blood pressure, complications, biochemical index and continuous glucose monitoring index were compared between the two groups of patients. The correlation between sDPN and TIR was analyzed. Logistic regression analysis was used to analyze influence factors of sDPN. Results Compared with the non-sDPN group, patients in the sDPN group were older and had longer diabetes course, higher systolic blood pressure (SBP), urinary albumin/urinary creatinine (UACR), blood glucose 1 h postprandial (1 h-PG), 2 h-PG, TBR, mean blood glucose fluctuation range (MAGE), standard deviation of blood glucose level (SD) and glycemic coefficient of variation (CV) levels, higher proportion of hypertension (HT), diabetic nephropathy (DN), diabetic retinopathy (DR) and diabetic peripheral vascular disease (PAD), and lower levels of total cholesterol (TC), right limb ankle brachial index (R-ABI), L-ABI, hemoglobin A1c (HbA1c) and TIR. The differences in the above indexes were statistically significant (P<0.05). The occurrence of sDPN was positively correlated with TBR (r_s=0.104, P<0.05), and negatively correlated with TIR (r_s=-0.093, P<0.05). Logistic regression analysis showed that increased TBR (OR=1.093,95%CI: 1.009-1.183), combined with DN (OR=3.004, 95%CI: 1.020-8.849) and DR (OR=9.736, 95%CI: 3.499-27.087) were independent risk factors for sDPN, and increased R-ABI (OR=0.005,95%CI: 0.000-0.424) was protective factor for sDPN. Conclusion sDPN was negatively correlated with TIR. For patients with T2DM complicated with DN, DR and decreased ABI, it is necessary to timely improve neuroelectrophysiological examination to identify sDPN as soon as possible and give early intervention.

Key words: diabetes mellitus, type 2, subclinical diabetic peripheral neuropathy, time in range, risk factor

CLC Number:

R587.1，R747.9

Figures/Tables 5

References 19

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组别	n	胰岛素	二甲双胍	α糖苷酶抑制剂	格列奈类	磺脲类	噻唑烷二酮类	DPP-4i	SGLT-2i	GLP-1RA	降压药
非sDPN组	276	89（32.2）	95（34.4）	71（25.7）	19（6.9）	28（10.1）	35（12.7）	22（8.0）	92（33.3）	49（17.8）	64（23.2）
sDPN组	209	82（39.2）	53（25.4）	52（24.9）	22（10.5）	17（8.1）	25（12.0）	16（7.7）	102（48.8）	32（15.3）	78（37.3）
χ²		2.544	4.606^＊	0.045	2.039	0.571	0.057	0.016	11.861^＊＊	0.510	11.472^＊＊

组别	n	胰岛素	二甲双胍	α糖苷酶抑制剂	格列奈类	磺脲类	噻唑烷二酮类	DPP-4i	SGLT-2i	GLP-1RA	降压药
非sDPN组	276	89（32.2）	95（34.4）	71（25.7）	19（6.9）	28（10.1）	35（12.7）	22（8.0）	92（33.3）	49（17.8）	64（23.2）
sDPN组	209	82（39.2）	53（25.4）	52（24.9）	22（10.5）	17（8.1）	25（12.0）	16（7.7）	102（48.8）	32（15.3）	78（37.3）
χ²		2.544	4.606^＊	0.045	2.039	0.571	0.057	0.016	11.861^＊＊	0.510	11.472^＊＊

组别	n	性别（男/女）	年龄/岁	病程/年	吸烟史	饮酒史	HT	CHD	CVD	DN	DR	PAD
非sDPN组	276	168/108	52.49±13.73	2.00（0.25，6.00）	103（37.3）	82（29.7）	108（39.1）	18（6.5）	15（5.4）	30（10.9）	25（9.1）	17（6.2）
sDPN组	209	109/100	57.02±11.73	7.00（3.00，10.00）	69（33.0）	50（23.9）	102（48.8）	19（9.1）	15（7.2）	61（29.2）	69（33.0）	32（15.3）
χ²、t或Z		3.689	3.824^＊＊	7.283^＊＊	0.963	2.011	4.533^＊	0.783	0.622	26.180^＊＊	43.685^＊＊	10.967^＊＊

组别	n	性别（男/女）	年龄/岁	病程/年	吸烟史	饮酒史	HT	CHD	CVD	DN	DR	PAD
非sDPN组	276	168/108	52.49±13.73	2.00（0.25，6.00）	103（37.3）	82（29.7）	108（39.1）	18（6.5）	15（5.4）	30（10.9）	25（9.1）	17（6.2）
sDPN组	209	109/100	57.02±11.73	7.00（3.00，10.00）	69（33.0）	50（23.9）	102（48.8）	19（9.1）	15（7.2）	61（29.2）	69（33.0）	32（15.3）
χ²、t或Z		3.689	3.824^＊＊	7.283^＊＊	0.963	2.011	4.533^＊	0.783	0.622	26.180^＊＊	43.685^＊＊	10.967^＊＊

组别	n		SBP/mmHg	DBP/mmHg		R-ABI		L-ABI		TG/（mmol/L）		TC/（mmol/L）	HDL-C/（mmol/L）		LDL-C/（mmol/L）
非sDPN组	276		133.6±21.1	82.9±12.3		1.17±0.10		1.14±0.09		1.55（1.08，2.41）		4.97±1.43	1.16±0.42		2.94（2.30，3.67）
sDPN组	209		139.0±23.4	81.5±13.7		1.11±0.13		1.10±0.13		1.36（0.97，1.98）		4.60±1.27	1.14±0.55		2.75（1.98，3.12）
t或Z			2.612^＊＊	1.220		4.186^＊＊		2.885^＊＊		1.179		2.865^＊＊	0.412		1.680
组别		Scr/（μmol/L）			UA/（μmol/L）		UACR/（mg/g）		FPG/（mmol/L）		1 h-PG/（mmol/L）			2 h-PG/（mmol/L）		HbA1c/%
非sDPN组		59.30（47.10，73.55）			345.64±145.00		115.03±31.89		7.20±2.24		13.49±3.25			15.28±2.87		9.62±2.91
sDPN组		62.75（48.70，82.10）			329.44±115.82		277.45±61.47		7.28±2.76		15.05±7.17			16.54±4.87		9.05±2.69
Z或t		1.400			1.251		2.838^＊＊		0.264		2.238^＊			2.479^＊		2.041^＊