Abstract: Background　Fibroblast growth factor 21 （FGF21） is a pleiotropic endocrine metabolism regulator，which can facilitate the regeneration of peripheral nerve axons and myelin sheaths in mice by inhibiting oxidative stress and inflammation. However，there are few studies on the correlation between FGF21 and diabetic peripheral neuropathy （DPN） in humans，and the mechanism of action is still unclear. Objective　To explore the correlation between serum FGF21 level and DPN. Methods　A total of 200 patients with type 2 diabetes were recruited from Hebei General Hospital from November 2019 to November 2020，including 109 with DPN and 91 without. Serum FGF21 was detected using ELISA，and other clinical data were collected. Pearson and Spearman rank correlation analysis was used to examine the correlation between serum FGF21 and various indicators. Binary Logistic regression analysis was performed to identify the influencing factors of DPN in type 2 diabetes. Results　The average serum FGF21 in patients with DPN was significantly higher than that in those without （P<0.05）. Correlation analysis showed that FGF21 was positively correlated with fasting plasma glucose，glycosylated hemoglobin，malondialdehyde，and TNF-α （r=0.184，r=0.156，rs=0.164，r=0.175，P<0.05），and was negatively correlated with the superoxide dismutase （r=-0.189，P<0.05）. Binary Logistic regression analysis showed that course of type 2 diabetes〔OR=1.499，95%CI（1.085，1.935）〕，malondialdehyde〔OR=1.242，95%CI（1.062，1.452）〕，TNF-α〔OR=1.036，95%CI（1.012，1.060）〕 and FGF21〔OR=1.007，95%CI（1.002，1.012）〕 were independent influencing factors for DPN in type 2 diabetes （P<0.05）. Conclusion　FGF21 is an independent influencing factor of DPN in type 2 diabetes，which can affect DPN by regulating glucose metabolism，inhibiting oxidative stress and inflammation.

Key words: Diabetes mellitus, type 2；Diabetic peripheral neuropathies；Fibroblast growth factor 21；Superoxide dismutase；Malondialdehyde；Tumor necrosis factor-alpha

摘要： 背景　成纤维细胞生长因子21（FGF21）是一种多效内分泌代谢调节因子，可通过抑制氧化应激和炎性反应促进小鼠周围神经轴突和髓鞘的再生。然而有关人体中FGF21与糖尿病周围神经病变（DPN）的相关性研究甚少，且作用机制尚不明确。目的　探讨血清FGF21水平与DPN的相关性。方法　选取2019年11月至2020年11月于河北省人民医院就诊的200例2型糖尿病（T2DM）患者为研究对象，根据是否合并DPN将其分为糖尿病周围神经病变组（DPN组）109例和非糖尿病周围神经病变组（NDPN组）91例。采用酶联免疫吸附试验（ELISA）检测两组患者血清FGF21水平并收集其临床资料。采用Pearson相关分析和Spearman秩相关分析探究血清FGF21水平与各指标的相关性，二元Logistic回归分析探究T2DM患者发生DPN的影响因素。结果　DPN组血清FGF21水平高于NDPN组（P<0.05）。相关性分析结果显示，T2DM患者FGF21与空腹血糖（FPG）、糖化血红蛋白（HbA1c）、丙二醛（MDA）、肿瘤坏死因子α（TNF-α）呈正相关（r=0.184、r=0.156、rs=0.164、r=0.175，P<0.05），与超氧化物歧化酶（SOD）呈负相关（r=-0.189，P<0.05）。二元Logistic回归分析结果显示，糖尿病病程〔OR=1.499，95%CI（1.085，1.935）〕、MDA〔OR=1.242，95%CI（1.062，1.452）〕、TNF-α〔OR=1.036，95%CI（1.012，1.060）〕和FGF21〔OR=1.007，95%CI（1.002，1.012）〕是T2DM患者发生DPN的独立影响因素（P<0.05）。结论　FGF21是T2DM患者发生DPN的独立影响因素，其可通过调节糖代谢、抑制氧化应激和炎性反应对DPN的发生产生影响。

关键词: 糖尿病, 2型；糖尿病周围神经病变；成纤维细胞生长因子21；超氧化物歧化酶；丙二醛；肿瘤坏死因子α