| BackgroundThe most common chronic complication of diabetes is diabetic neuropathy,and diabetic peripheral neuropathy(DPN)accounts for the highest proportion of all types of diabetic neuropathy,which reduces the quality of life of patients and causes a great loss to society.However,due to the lack of knowledge about DPN,no specific treatment is available.Previous studies have found that early recognition and treatment can delay the progression of DPN and reduce discomfort and pain.Previous studies have shown a strong relationship between serum 25hydroxyvitamin D3 levels and diabetic peripheral neuropathy.ObjectivesTo investigate the correlation between serum 25hydroxyvitamin D3 levels and diabetic peripheral neuropathy in patients with newly diagnosed type 2 diabetes mellitus(T2DM).To screen for risk factors for the development of peripheral neuropathy in patients with newly diagnosed T2DM.To explore new treatment ideas for the early prevention and treatment of DPN.MethodsA retrospective case-control study was conducted on 337 newly diagnosed T2DM patients,199 males and 138 females,hospitalized in the Department of Endocrinology,Third Affiliated Hospital of Southern Medical University between March 2019 and October 2022.According to the DPN diagnostic criteria in the Expert Consensus on the Diagnosis and Treatment of Diabetic Neuropathy(2021 Edition),after the consultation,physical examination and neurophysiological examination,all study subjects were divided into two groups:the group of type 2 diabetic patients without peripheral lesions(NDPN group)and the group of type 2 diabetic patients with peripheral lesions(DPN group).General data of the study subjects were collected including name,gender,age,height,weight,body mass index,systolic diastolic blood pressure;biochemical indices were collected including glycosylated hemoglobin,serum 25 hydroxyvitamin D3,total cholesterol,triglycerides,LDL,HDL,blood uric acid,blood creatinine,serum calcium ion,serum phosphorus ion,and urine microalbumin creatinine ratio.The general data and biochemical indices were compared between the two groups.Univariate and multifactorial analyses were used to explore the risk factors associated with DPN in patients with newly diagnosed T2DM.Subject work characteristic curve analysis was used to predict the critical value of 25 hydroxyvitamin D3 at the onset of DPN.ResultThe proportion of male subjects in this study was higher than that of female,and the mean age of the peripheral neuropathy group was 54.1 years,which was significantly higher than that of the non-peripheral neuropathy group,which was 51.4 years.The mean value of 25hydroxyvitamin D3 was lower in diabetic patients with peripheral neuropathy than in those without peripheral neuropathy.In the correlation analysis,both age and glycosylated hemoglobin level were positively associated with the incidence of diabetic peripheral neuropathy,and 25hydroxyvitamin D3 was negatively associated with the incidence of diabetic peripheral neuropathy;in logistic regression analysis,controlling for the effects of gender and age variables,the effects of 25hydroxyvitamin D3 grouping and glycosylated hemoglobin level on diabetic peripheral neuropathy were found to remained significant(P<0.05)with OR values of 0.53(95%CI:0.33-0.86)and 2.03(95%CI:1.69-2.40),respectively.The results showed that the 25hydroxyvitamin D3 subgroup performed well in the diagnosis of diabetic peripheral neuropathy with an area under the ROC curve(AUC)of 0.628,and a 25 hydroxyvitamin D3 value of 60.72 was the best cut-off point for predicting the onset of peripheral neuropathy.Conclusion1 Serum 25 hydroxyvitamin levels in newly diagnosed type 2 diabetic patients have a negative correlation with diabetic peripheral neuropathy.Age and glycosylated hemoglobin levels were positively correlated with peripheral neuropathy.2 Low levels of 25 hydroxyvitamin D and high levels of glycosylated hemoglobin were independent risk factors for peripheral neuropathy in newly diagnosed type 2 diabetic patients. |
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