Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Endocrinol Metab (Seoul). 2022 Apr;37(2):243-248. doi: 10.3803/EnM.2021.1337. Epub 2022 Apr 25.
Clonal hematopoiesis of indeterminate potential (CHIP) has been reported to be associated with increased cardiovascular disease, aging and insulin resistance. Despite the debate of causal contribution of CHIP on metabolic diseases, we want to explore whether CHIP is related to diabetic peripheral neuropathy (DPN).
This study analyzed the prevalence of CHIP in patients with type 2 diabetes classified according to DPN status. Logistic regression analysis was used to evaluate the association between CHIP and DPN.
CHIP was more prevalent in subjects without DPN than those with DPN (19.9% vs. 8.8%, respectively; P=0.013). Individuals having any CHIP, or DNA methyltransferase 3A (DNMT3A) CHIP were less likely to have any abnormality shown in DPN test; the adjusted odds ratio were 0.85 (95% confidence interval [CI], 0.73 to 1.00) and 0.70 (95% CI, 0.56 to 0.89), respectively. Interestingly, DNMT3A CHIP showed the negative association, but Tet methylcytosine dioxygenase 2 (TET2) CHIP showed the positive association with abnormal feet electrochemical skin conductance level.
On the contrary to expectations, CHIP was negatively associated with DPN. Functional linking between the mutation in hematopoietic cells and DPN, and the opposite role of DNMT3A and TET2 should be investigated.
不定潜能的克隆性造血（CHIP）已被报道与心血管疾病、衰老和胰岛素抵抗的风险增加有关。尽管关于 CHIP 对代谢疾病的因果贡献存在争议，但我们想探讨 CHIP 是否与糖尿病周围神经病变（DPN）有关。
本研究根据 DPN 状态对 2 型糖尿病患者进行了 CHIP 患病率分析。采用逻辑回归分析评估 CHIP 与 DPN 之间的关联。
无 DPN 的受试者中 CHIP 的患病率高于有 DPN 的受试者（19.9% vs. 8.8%；P=0.013）。存在任何 CHIP 或 DNA 甲基转移酶 3A（DNMT3A）CHIP 的个体发生 DPN 检查任何异常的可能性较低；调整后的优势比分别为 0.85（95%置信区间 [CI]，0.73 至 1.00）和 0.70（95% CI，0.56 至 0.89）。有趣的是，DNMT3A CHIP 显示出负相关，而 Tet 甲基胞嘧啶双加氧酶 2（TET2）CHIP 与异常足部电化学皮肤电导率水平呈正相关。
与预期相反，CHIP 与 DPN 呈负相关。应研究造血细胞突变与 DPN 之间的功能联系，以及 DNMT3A 和 TET2 的相反作用。
