血清NfL、Hcy、Metrnl水平与老年2型糖尿病周围神经病变的关系

doi:10.3969/j.issn.1003-9198.2025.10.013

摘要/Abstract

摘要： 目的探讨血清神经丝轻链(NfL)、Hcy、流星样蛋白(Metrnl)水平与老年2型糖尿病周围神经病变(DPN)的相关性,以期为老年DPN的早期诊断提供新的参考指标。方法选取2022年7月至2024年6月期间陕西省核工业二一五医院收治的81例老年T2DM病人,根据是否发生DPN分为病变组(n=31)和非病变组(n=50)。收集所有研究对象的一般临床信息,并采用酶联免疫吸附法检测血清NfL、Hcy、Metrnl水平,比较2组上述指标的差异。采用多因素logistic回归分析老年DPN发生的影响因素,绘制ROC曲线比较各指标对老年DPN的诊断价值。结果病变组病程更长,NfL、Hcy和FPG水平高于非病变组,Metrnl和空腹C肽水平低于非病变组(P<0.05)。多因素logistic回归分析显示,病程长、高FPG、高NfL、高Hcy均为T2DM病人发生DPN的危险因素,高Metrnl、空腹C肽高水平为保护因素(P<0.05)。ROC曲线分析显示,NfL、Hcy、Metrnl联合诊断DPN的AUC为0.968,敏感度和特异度分别为93.55%和90.00%,优于各指标单独诊断(P<0.05)。结论老年DPN病人血清NfL、Hcy水平显著升高,Metrnl水平明显降低,三者均可作为老年DPN的早期诊断指标,且联合检测的诊断效能更高。

关键词: 神经丝轻链, 同型半胱氨酸, 流星样蛋白, 2型糖尿病, 周围神经病变

Abstract: Objective To explore the correlations of the levels of serum neurofilament light chain (NfL), homocysteine (Hcy), and meteorin-like protein (Metrnl) with diabetic peripheral neuropathy (DPN) in the elderly with type 2 diabetes mellitus(T2DM), so as to provide new reference indicators for the early diagnosis of DPN in the elderly. Methods From July 2022 to June 2024, 81 elderly patients with T2DM admitted to NO.215 Hospital of Shaanxi Nuclear Industry were divided into DPN group (n=31) and non-DPN group (n=50) according to whether DPN occurred. The general clinical information of all the patients were collected, and enzyme linked immunosorbent assay was used to detect the serum levels of NfL, Hcy, and Metrnl. Multivariate logistic regression was used to analyze the influencing factors for DPN in the elderly T2DM patients. The diagnostic value of each indicator for DPN was analyzed by the receiver operating characteristic(ROC) curve. Results The course of disease in DPN group was significantly longer than that in non-DPN group(P<0.05). The levels of NfL, Hcy and fasting plasma glucose(FPG) in DPN group were higher and the levels of Metrnl and fasting C-peptide were lower than those in non-DPN group (P<0.05). Multivariate logistic regression suggested that long disease duration, high levels of FPG, NfL and Hcy were risk factors for DPN in elderly T2DM patients, while high levels of fasting C-peptide and Metrnl were protective factors for DPN (P<0.05). The area under curve (AUC) of combined diagnosis was 0.968, with a sensitivity and specificity of 93.55% and 90.00%, respectively, which was better than those of individual diagnosis (P<0.05). Conclusions The serum levels of NfL and Hcy are significantly increased, and the Metrnl level is significantly decreased in elderly DPN patients. The three indicators could be used as early diagnostic indicators for DPN, and the combined detection is of great significance to improve the diagnostic efficacy.

Key words: neurofilament light chain, homocysteine, meteorin-like protein, type 2 diabetes mellitus, peripheral neuropathy

中图分类号:

R 587.1

张欢欢, 李荣荣. 血清NfL、Hcy、Metrnl水平与老年2型糖尿病周围神经病变的关系[J]. 实用老年医学, 2025, 39(10): 1033-1037.

ZHANG Huanhuan, LI Rongrong. Relationship between serum levels of NfL, Hcy, Metrnl and peripheral neuropathy in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2025, 39(10): 1033-1037.

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