Zhao Subei, Yang Zheng, Yu Meng, Xiang Linyu, Lv Yuhuan, Tian Chunyan, Li Rong
Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Oct 18;16:3249-3259. doi: 10.2147/DMSO.S431551. eCollection 2023.
Subclinical inflammation may be involved in the pathogenesis of diabetic cardiac autonomic neuropathy (DCAN). The purpose of the study is to explore the relationship between novel inflammation biomarkers fibrinogen-albumin ratio (FAR), fibrinogen-prealbumin ratio (FPR), and DCAN in type 2 diabetes mellitus (T2DM).
A total of 715 T2DM patients were enrolled in this retrospective study, divided into non-DCAN (n=565) and DCAN (n=150) groups by Ewing's test. Serum fibrinogen, albumin, prealbumin, routine inflammatory and other biochemical markers were measured.
Patients with versus without DCAN had higher FAR (10.29 ± 4.83 vs 7.22 ± 2.56 g/g, P < 0.001) and FPR (2.19 ± 1.85 vs 1.43 ± 0.93 g/mg, P < 0.001). As FAR and FPR quartiles increased, the incidence of DCAN increased (Quartile 1 vs Quartile 4: 8.4 vs 42.7%, 9.6 vs 39.2%, respectively, P < 0.001), heart rate variability parameters decreased (P < 0.001); the incidence of diabetic nephropathy, retinopathy and peripheral neuropathy tended to be higher and inflammation factors were more active (P < 0.01). FAR (OR, 95% CI: 1.16, 1.08-1.25, P < 0.001) and FPR (OR, 95% CI: 1.22, 1.03-1.44, P = 0.021) were independent determinants of DCAN; the risk of DCAN increased by approximately 65% and 27% with each increase in the standard deviation (SD) of FAR (OR per SD, 95% CI: 1.65, 1.29-2.11, P < 0.001) and FPR (OR per SD, 95% CI: 1.27, 1.04-1.56, P = 0.021).
FAR and FPR are independent risk factors and may influence DCAN development through inflammation.
亚临床炎症可能参与糖尿病心脏自主神经病变（DCAN）的发病机制。本研究旨在探讨新型炎症生物标志物纤维蛋白原-白蛋白比值（FAR）、纤维蛋白原-前白蛋白比值（FPR）与2型糖尿病（T2DM）患者DCAN之间的关系。
本回顾性研究共纳入715例T2DM患者，通过尤因试验分为非DCAN组（n = 565）和DCAN组（n = 150）。检测血清纤维蛋白原、白蛋白、前白蛋白、常规炎症指标及其他生化指标。
与无DCAN的患者相比，有DCAN的患者FAR（10.29±4.83 vs 7.22±2.56 g/g，P<0.001）和FPR（2.19±1.85 vs 1.43±0.93 g/mg，P<0.001）更高。随着FAR和FPR四分位数的增加，DCAN的发生率升高（四分位数1 vs四分位数4：分别为8.4% vs 42.7%，9.6% vs 39.2%，P<0.001），心率变异性参数降低（P<0.001）；糖尿病肾病、视网膜病变和周围神经病变的发生率趋于更高，炎症因子更活跃（P<0.01）。FAR（OR，95%CI：1.16，1.08 - 1.25，P<0.001）和FPR（OR，95%CI：1.22，1.03 - 1.44，P = 0.021）是DCAN的独立决定因素；FAR（每标准差OR，95%CI：1.65，1.29 - 2.11，P<0.001）和FPR（每标准差OR，95%CI：1.27，1.04 - 1.56，P = 0.021）每增加一个标准差，DCAN的风险分别增加约65%和27%。
FAR和FPR是独立的危险因素，可能通过炎症影响DCAN的发生发展。
