Department of Endocrinology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China.
Front Endocrinol (Lausanne). 2023 Feb 27;14:1064125. doi: 10.3389/fendo.2023.1064125. eCollection 2023.
Despite previous research that focused on aspartate aminotransferase/alanine aminotransferase ratio (AAR) as predictors of type 2 diabetes mellitus (T2DM) and cardiovascular disease, there has been limited research evaluating the association between AAR and diabetic microvascular complications. This study aimed to investigate the association of AAR with diabetic peripheral neuropathy (DPN).
A total of 1562 hospitalized patients with T2DM were divided into four groups according to AAR quartiles. The relationship between AAR and DPN and related parameters was explored by the Spearman correlation coefficients, multivariable logistic regression analysis, and receiver operating characteristic (ROC) curves.
Patients with higher AAR quartiles had higher levels of vibration perception threshold (VPT) and presence of DPN, and AAR was positively associated with VPT and presence of DPN independent of sex, age, body mass index, and diabetic duration (P<0.01 or P<0.05). Moreover, AAR remained significantly associated with a higher odds ratio (OR) of DPN (OR 2.413, 95% confidence interval [CI] 1.081-5.386, P<0.05) after multivariate adjustment. Additionally, the risk of presence of DPN increased progressively as AAR quartiles increased (all P for trend <0.01) in both male and female subjects, and the highest quartile of AAR of male and female subjects was respectively associated with 107.3% (95% CI: 1.386-3.101; P<0.01) and 136.8% (95% CI: 1.550-3.618; P<0.01) increased odds of DPN compared with the lower quartiles. Last, the analysis of receiver operating characteristic curves revealed that the best cutoff values for AAR to predict the presence of DPN were 0.906 (sensitivity: 70.3%; specificity: 49.2%; and area under the curve [AUC]: 0.618) and 1.402 (sensitivity: 38%; specificity: 81.9%; and AUC: 0.600) in male and female subjects, respectively.
These findings suggest that the high AAR may be associated with the presence of DPN in Chinese patients with T2DM, and may be used as an additional indicator of risk of DPN.
尽管之前有研究关注天门冬氨酸氨基转移酶/丙氨酸氨基转移酶比值(AAR)作为 2 型糖尿病(T2DM)和心血管疾病的预测因子,但评估 AAR 与糖尿病微血管并发症之间关系的研究有限。本研究旨在探讨 AAR 与糖尿病周围神经病变(DPN)之间的关系。
根据 AAR 四分位数,将 1562 名住院 T2DM 患者分为四组。通过 Spearman 相关系数、多变量逻辑回归分析和受试者工作特征(ROC)曲线探讨 AAR 与 DPN 及相关参数的关系。
AAR 四分位较高的患者振动感觉阈值(VPT)水平和 DPN 的发生率较高,AAR 与 VPT 和 DPN 的发生独立于性别、年龄、体重指数和糖尿病病程呈正相关(P<0.01 或 P<0.05)。此外,在多变量调整后,AAR 与 DPN 的比值比(OR)仍显著相关(OR 2.413,95%置信区间 [CI] 1.081-5.386,P<0.05)。此外,随着 AAR 四分位的升高,男性和女性受试者中 DPN 的发生率呈递增趋势(所有趋势 P 值<0.01),男性和女性受试者的 AAR 最高四分位数与 DPN 的比值比分别为 107.3%(95%CI:1.386-3.101;P<0.01)和 136.8%(95%CI:1.550-3.618;P<0.01)。最后,ROC 曲线分析显示,AAR 预测 DPN 存在的最佳截断值在男性和女性受试者中分别为 0.906(灵敏度:70.3%;特异性:49.2%;曲线下面积 [AUC]:0.618)和 1.402(灵敏度:38%;特异性:81.9%;AUC:0.600)。
这些发现表明,在中国 T2DM 患者中,高 AAR 可能与 DPN 的发生有关,AAR 可能作为 DPN 风险的附加指标。