目的 探究25-羟维生素D[25-（OH）D]水平预测糖尿病周围神经病变发生的相关性。方法 选取2021年6月—2021年12月间在上海市静安区南京西路社区卫生服务中心就诊的200例2型糖尿病患者为研究对象,根据体格检查、血液生化、神经症状评分、肌电图等方法分为无周围神经病变组（n=153）和周围神经病变组（n=47）,对比两组患者的一般资料及血清基线25-（OH）D水平,分析25-（OH）D与糖尿病周围神经病变的相关性,采用Logistic回归分析25-（OH）D对糖尿病周围神经病变的预测价值。结果 两组患者基线25-（OH）D水平、空腹血糖、糖化血红蛋白（HbA_1c）、收缩压对比差异有统计学意义（P<0.001）,而年龄、性别、BMI、腰围、餐后血糖值、谷草转氨酶、空腹C肽、总胆固醇、高密度脂蛋白胆固醇、甘油三酯、低密度脂蛋白胆固醇（LDL-C）、血肌酐、血尿酸、舒张压对比无明显差异（P>0.05）;基线25-（OH）D水平与密歇根糖尿病周围神经病变评分（MDNS）呈负相关（r=-0.583,P<0.001）,空腹血糖与MDNS评分呈正相关（r=0.303,P<0.001）;Logistic回归分析提示,25-（OH）D每增加一个单位,糖尿病周围神经病变风险下降25%,校正性别、年龄、HbA_1c、LDL后,相关性依然存在。结论 25-（OH）D水平与糖尿病周围神经病变呈负相关,与该病的发生及发展密切相关,血清25-（OH）D水平可作为预测尿病周围神经病变发生、发展的重要指标。

Objective To explore the correlation of 25-hydroxyvitamin D[25-（OH）D] level in predicting the occurrence of diabetic peripheral neuropathy．Methods A total of 200 patients with type 2 diabetes mellitus（T2DM）who were admitted to Community Health Service Center of West Nanjing Road,Jing’an District,Shanghai from June 2021 and December 2021 were selected as the study subjects．According to physical examination,blood biochemistry,neurological symptom score and electromyography,the patients were divided into two groups：no peripheral neuropathy group（n=153）and peripheral neuropathy group（n=47）．The general data and serum baseline 25-（OH）D levels of the two groups were compared to analyze the correlation between 25-（OH）D and diabetic peripheral neuropathy．The predictive value of 25-（OH）D in diabetic peripheral neuropathy was analyzed by Logistic regression．Results There were significant differences in baseline 25-（OH）D level,fasting blood glucose（FBG）,HbA_1c and SBP between two groups（P<0.001）,but no significant differences in age,sex,BMI,waist circumference,postprandial plasma glucose,AST,C-peptid total cholesterol,HDL-C,triglyceride,LDL-C,Scr,UA and DBP between two groups（P>0.05）．Baseline 25-（OH）D level was negatively correlated with MDNS score（r=-0.583,P<0.001）,and FBG was positively correlated with MDNS score（r=0.303,P<0.001）．Logistic regression analysis showed that the DPN risk decreased by 25% for every unit increase of 25-（OH）D,and the correlation remained after timely adjustment for sex,age,HbA_1c,and LDL-C．Conclusion sThe level of 25-（OH）D is negatively correlated with the occurrence and development of diabetic peripheral neuropathy,and the detection of serum 25-（OH）D level can be used as an important indicator to predict the occurrence and development of urinary peripheral neuropathy．

目的 研究联合电生理检查用于糖尿病周围神经病变早期诊断的价值。方法 选取160例糖尿病患者,根据患者是否存在肢体麻木、疼痛、无力、烧灼感或凉感等周围神经损伤临床症状,将患者分为有症状组84例,无症状组76例。所有患者均行电生理检查,检测神经传导(nerve conduction studies,NCS)及F波,检测指标包括运动神经运动末端潜伏期(distal motor latency,DML)、复合肌肉动作电位(compound muscle action potential,CMAP)波幅、感觉神经动作电位(sensory nerve action potentia,SNAP)波幅、感觉神经传导速度(sensory nerve conduction velocity,SCV)、F波平均潜伏期(Flmean)、F波离散度(Fchd)。比较2组电生理检查指标。结果 有症状组胫神经及腓总神经DML均高于无症状组(P＜0.05),胫神经及腓总神经CAMP均低于无症状组(P＜0.05)。有症状组正中神经、尺神经、胫神经及腓总神经SCV、SNAP均低于无症状组(P＜0.05)。有症状组正中神经及胫神经Flmean、Fchd均高于无症状组(P＜0.05)。NCS、F波联合诊断糖尿病周围神经病变的灵敏度为0.857、特异度0.829、准确率0.844、阳性预测值为0.847、阴性预测值为0.840、kappa值0.687。结论 糖尿病周围神经病变早期联合电生理检查具有一定价值。