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血清 CCL11/嗜酸性粒细胞趋化因子-1 水平升高与 2 型糖尿病患者的糖尿病感觉运动多发性神经病和周围神经功能有关,但与心脏自主神经病变无关。

High serum levels of CCL11/Eotaxin-1 are associated with diabetic sensorimotor polyneuropathy and peripheral nerve function but not with cardiac autonomic neuropathy in people with type 2 diabetes.

机构信息

Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan.

出版信息

Postgrad Med. 2024 Apr;136(3):318-324. doi: 10.1080/00325481.2024.2347196. Epub 2024 Apr 29.

Abstract

AIMS

To investigate whether higher serum CCL11/Eotaxin-1, a biomarker for aging and neurodegenerative and neuroinflammatory disorders, is associated with diabetic sensorimotor polyneuropathy (DSPN), peripheral nerve dysfunction, and cardiac autonomic neuropathy in people with type 2 diabetes.

METHODS

This cross-sectional study included 106 patients with type 2 diabetes and 40 healthy controls, matched for the age and sex distribution of the diabetes group as a whole. The CC chemokines CCL11/Eotaxin-1 and CCL22/MDC were measured in fasting serum samples. DSPN and peripheral nerve function were assessed by neurological examination and nerve conduction studies, and cardiac autonomic function, by heart rate variability (HRV) and corrected QT (QTc) time. The cardio-ankle vascular index (CAVI) was measured as a marker for arterial stiffness.

RESULTS

Serum CCL11/Eotaxin-1 levels were significantly higher in diabetic patients than in healthy controls (183 ± 63.5 vs. 113.1 ± 38.5 pg/ml,  < 0.001), but serum CCL22/MDC levels were not significantly different between the two groups. In the diabetes group, the serum CCL11/Eotaxin-1 level was positively correlated with ulnar and sural nerve conduction velocities ( = 0.0009,  = 0.0208, respectively) and sensory nerve action potential ( = 0.0083), and CAVI ( = 0.0005), but not with HRV indices or QTc time, and serum CCL22/MDC was not significantly correlated with any indices of nerve conduction. In a model adjusted for age and duration of diabetes, serum CCL11/Eotaxin-1 was still associated with ulnar nerve conduction velocity ( = 0.02124). Serum CCL11/Eotaxin-1, but not CCL22/MDC, was significantly higher in patients with than in those without DSPN (208.2 ± 71.6 vs. 159.1 ± 45.1 pg/ml, respectively;  < 0.0001).

CONCLUSIONS

Serum CCL11/Eotaxin-1 is elevated in patients with DSPN and is associated with peripheral nerve dysfunction, in particular sensory nerve conduction velocity, suggesting that serum CCL11/Eotaxin-1 may be a potential biomarker for DSPN.

CLINICAL TRIAL REGISTRATION

University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000040631).

摘要

目的

研究血清趋化因子 CCL11/嗜酸性粒细胞趋化因子-1(一种与衰老、神经退行性和神经炎症疾病相关的生物标志物)是否与 2 型糖尿病患者的糖尿病感觉运动性多发性神经病(DSPN)、周围神经功能障碍和心脏自主神经病变有关。

方法

本横断面研究纳入了 106 例 2 型糖尿病患者和 40 名健康对照者,这些对照者与糖尿病组的年龄和性别分布相匹配。在空腹血清样本中测量 CC 趋化因子 CCL11/嗜酸性粒细胞趋化因子-1 和 CCL22/巨噬细胞衍生趋化因子。通过神经学检查和神经传导研究评估 DSPN 和周围神经功能,通过心率变异性(HRV)和校正 QT(QTc)时间评估心脏自主神经功能,通过血管钙化指数(CAVI)评估动脉僵硬程度。

结果

与健康对照组相比,糖尿病患者的血清 CCL11/嗜酸性粒细胞趋化因子-1 水平显著升高(183±63.5 与 113.1±38.5 pg/ml,  < 0.001),但两组间血清 CCL22/巨噬细胞衍生趋化因子水平无显著差异。在糖尿病组中,血清 CCL11/嗜酸性粒细胞趋化因子-1 水平与尺神经和腓肠神经传导速度呈正相关(  = 0.0009,  = 0.0208),与感觉神经动作电位呈正相关(  = 0.0083),与 CAVI 呈正相关(  = 0.0005),但与 HRV 指数或 QTc 时间无关,而血清 CCL22/巨噬细胞衍生趋化因子与任何神经传导指数均无显著相关性。在调整年龄和糖尿病病程的模型中,血清 CCL11/嗜酸性粒细胞趋化因子-1 仍与尺神经传导速度相关(  = 0.02124)。与无 DSPN 患者相比,血清 CCL11/嗜酸性粒细胞趋化因子-1 在有 DSPN 患者中明显更高(208.2±71.6 与 159.1±45.1 pg/ml,  < 0.0001)。

结论

DSPN 患者的血清 CCL11/嗜酸性粒细胞趋化因子-1 水平升高,与周围神经功能障碍特别是感觉神经传导速度相关,提示血清 CCL11/嗜酸性粒细胞趋化因子-1 可能是 DSPN 的潜在生物标志物。

临床试验注册

大学医院医疗信息网(UMIN)临床试验注册(UMIN000040631)。

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