Abstract: Background　Diabetic peripheral neuropathy（DPN），is a common chronic complication of diabetes in elderly diabetic patients，seriously affecting the health of patients．At present，there is no effective prediction method for the risk of DPN.It has been found that the ratio of serum triacylglycerol to high-density lipoprotein-cholesterol（TG/HDL-C） has a certain predictive value for insulin resistance and cardiovascular and cerebrovascular diseases，but its relationship with DPN is rarely reported.Objective　To investigate the relationship between the ratio of TG/HDL-C and DPN in elderly type 2 diabetic patients（T2DM）.Methods　298 elderly T2DM patients were recruited from Department of Endocrinology，The Second People's Hospital of Lu'an City from January 2018 to June 2019，among whom there were 148 with DPN（DPN group） and 150 without（control group）.The indices of the two groups，such as gender ratio，average age，duration of diabetes，DPN course，hypertension history，smoking history，drinking history，waist circumference，systolic blood pressure （SBP），diastolic blood pressure （DBP），fasting plasma glucose（FPG），HbA1c，C-peptide（C-P），TC，TG，HDL-C，LDL-C，creatinine（Cr），UA，Cys-C，ALT，AST and ratio of TG/HDL-C，were compared.Binary Logistic regression analysis was carried out to identify the factors associated with DPN.Receiver operating characteristic（ROC）curve analysis was adopted to analyze the predictive value of TG/HDL-C ratio for DPN.Results　There were no significant differences between the two groups in the aspects of gender ratio，average age，duration of diabetes，and DPN course，prevalence of hypertension and drinking，average DBP，FPG，HbA1c，C-P，TC，HDL-C，LDL-C，Cr，UA，Cys-C，ALT and AST（P>0.05）.DPN group had higher prevalence of smoking，greater average waist circumference，SBP，TG and TG/HDL-C ratio than the control group（P<0.05）.Binary Logistic regression analysis revealed that smoking history and TG/HDL-C ratio were associated with DPN（P<0.05）.The AUC of the ROC curve drawn with TG/HDL-C ratio as the diagnostic variable was 0.627〔95%CI（0.563，0.690），P<0.001〕，when the optimal cut-off point of diagnosis was determined as 3.74，with 34.46% sensitivity，and 93.33% specificity.Conclusion　Elderly T2DM patients with high ratio of TG/HDL-C may be more likely to suffer from DPN.The detection of the ratio of TG/HDL-C is expected to be applied to clinical risk assessment and prediction of DPN in such patients.

Key words: TG/HDL-C ratio；Diabetes mellitus, type2；Diabetic peripheral neuropathy；Aged

摘要： 背景　糖尿病周围神经病变（DPN）是老年糖尿病患者常见的慢性并发症之一，严重影响患者的健康。目前针对DPN的发生风险尚无有效的预测手段。有研究发现血清三酰甘油/高密度脂蛋白胆固醇（TG/HDL-C）比值对胰岛素抵抗及心脑血管疾病有一定的预测价值，但关于其与DPN关系的研究较少。目的　探讨TG/HDL-C比值对老年2型糖尿病患者并发DPN的预测价值。方法　选取2018年1月—2019年6月六安市第二人民医院内分泌科收治的老年2型糖尿病患者298例为研究对象，未并发DPN患者150例（对照组），并发DPN患者148例（DPN组），比较两组研究对象性别、年龄、糖尿病（DM）病程、DPN病程、高血压史、吸烟史、饮酒史、腰围、收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、C肽（C-P）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、肌酐（Cr）、尿酸（UA）、胱抑素C（Cys-C）、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、TG/HDL-C比值等指标，采用多因素Logistic回归分析探讨老年糖尿病患者并发DPN的影响因素，采用受试者工作特征（ROC）曲线分析TG/HDL-C比值对老年糖尿病患者并发DPN的预测价值。结果　对照组与DPN组患者性别、年龄、DM病程、DPN病程、高血压史、饮酒史、DBP、FPG、HbA1c、C-P、TC、HDL-C、LDL-C、Cr、UA、Cys-C、ALT、AST比较，差异无统计学意义（P>0.05）；DPN组患者有吸烟史占比、腰围、SBP、TG、TG/HDL-C比值高于对照组，差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：有吸烟史和TG/HDL-C比值高是T2DM患者并发DPN的危险因素（P<0.05）。以TG/HDL-C比值为诊断变量绘制ROC曲线，结果显示AUC为0.627〔95%CI（0.563，0.690），P<0.001〕，诊断的最佳切点值为3.7，此时的灵敏度为34.5%，特异度为93.3%。结论　TG/HDL-C比值高的老年糖尿病患者可能更易发生DPN，TG/HDL-C比值检测有望用于临床上老年糖尿病患者并发DPN的风险评估和预测。

关键词: 三酰甘油/高密度脂蛋白胆固醇；糖尿病, 2型；糖尿病周围神经病变；老年人