血清CEA、Hcy、ADA与2型糖尿病患者发生周围神经病变的关系OA

Objective To investigate the relationship between serum carcinoembryonic antigen(CEA),ho-mocysteine(Hcy),adenosine deaminase(ADA)and peripheral neuropathy in patients with type 2 diabetes mellitus(T2DM).Methods A total of 100 patients with T2DM and peripheral neuropathy who were treated in Central Hospital of Fengxian District from January to December 2022 were selected as T2DM complicated group,and 100 patients with T2DM alone were selected as T2DM group.According to the Toronto Clinical scoring system,the patients in the T2DM complicated group were divided into mild,moderate and severe pe-ripheral neuropathy.Baseline data of all subjects were collected.The levels of serum CEA,Hcy and ADA were detected in all subjects.Pearson and Spearman correlation analysis were used to analyze the correlation be-tween CEA,Hcy,ADA levels and FBG,HbA1c levels and the severity of peripheral neuropathy in T2DM complicated group.Multivariate Logistic regression was used to analyze the influencing factors of peripheral neuropathy in T2DM patients.Receiver operating characteristic(ROC)curve was drawn to analyze the diag-nostic value of CEA,Hcy and ADA alone and combined detection for peripheral neuropathy in T2DM pa-tients.Results The course of disease in the T2DM complicated group was longer than that in the T2DM group,and the levels of fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),CEA,Hcy and ADA were higher than those in the T2DM group,and the differences were statistically significant(P<0.05).There were 26 cases of mild peripheral neuropathy,43 cases of moderate peripheral neuropathy and 31 cases of severe peripheral neuropathy in T2DM complicated group.The levels of CEA,Hcy and ADA in patients with severe peripheral neuropathy were higher than those in patients with moderate and mild peripheral neuropathy,and the levels of CEA,Hcy and ADA in patients with moderate peripheral neuropathy were higher than those in patients with mild peripheral neuropathy,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that the levels of CEA,Hcy and ADA were positively correlated with FBG and HbA1c in the T2DM complicated group(P<0.05).Spearman correlation analysis showed that the levels of CEA,Hcy and ADA were positively correlated with the severity of peripheral neuropathy in the T2DM com-plicated group(P<0.05).Multivariate Logistic regression analysis showed that long course of disease,and increased levels of FBG,HbA1c,CEA,Hcy and ADA were risk factors for T2DM peripheral neuropathy(P<0.05).After adjusting for course of disease,FBG and HbA1c,elevated levels of CEA,Hcy and ADA were still risk factors for T2DM peripheral neuropathy(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of CEA,Hcy and ADA alone in the diagnosis of peripheral neuropathy in T2DM patients was 0.835,0.831 and 0.783 respectively,and the AUC of the combination of the three in the diagnosis of peripher-al neuropathy in T2DM patients was 0.940.The AUC of the combination of CEA,Hcy and ADA in the diag-nosis of peripheral neuropathy in T2DM patients was greater than that of CEA,Hcy and Ada alone(Z=3.205,3.328,4.333,P<0.05).Conclusion The levels of CEA,Hcy and ADA are increased in patients with T2DM complicated with peripheral neuropathy,and the levels of the three are positively correlated with the severity of peripheral neuropathy.The combination of CEA,Hcy and ADA has a high value in the diagnosis of peripheral neuropathy in patients with T2DM.