Han Pingping, Hu Fan, Guo Jia, Xu Leirui, Zhang Junxia
Department of Endocrinology, Central Theater Command General Hospital of the Chinese PLA, Wuhan, 430070, China.
College of Medicine, Wuhan University of Science and Technology, Wuhan, 430065, Hubei Province, China.
Hormones (Athens). 2025 Mar;24(1):99-107. doi: 10.1007/s42000-024-00592-5. Epub 2024 Aug 19.
Distal symmetric polyneuropathy (DSPN) is one of the most common chronic complications in patients with type 2 diabetes mellitus (T2DM). Our previous study found that serum C1q tumor necrosis factor-related protein 3 (CTRP3) levels were decreased in type 2 diabetic patients. Thus, this study was designed to reveal the relationship between low serum CTRP3 and the prevalence and severity of DSPN.
A total of 178 cases of patients with T2DM were enrolled in the study. The subjects were divided into the DSPN group (n = 89) and the non-DSPN group (n = 89). Both anthropometric parameters and neurologic symptoms were recorded. Furthermore, neurologic signs, the neuropathy symptom score (NSS), and the neuropathy disability score (NDS) were assessed. Biochemical indexes, fasting insulin, and C peptide were measured. Serum CTRP3 concentrations were assayed using the ELISA method.
Serum CTRP3 levels decreased significantly in the DSPN group compared with the non-DSPN group (P < 0.05). CTRP3 was negatively associated with the number of positive signs, NSS score, and NDS score in patients with DSPN (all P < 0.05). Interestingly, the higher the NSS score or NDS score, the lower were the levels of serum CTRP3 (all P < 0.05). Moreover, patients with lower CTRP3 levels (< 7.58ng/ml) had a higher rate of neurologic signs (all P < 0.05). Binary logistic regression analysis showed that CTRP3 independently predicted the occurrence of DSPN (β = -0.316, P < 0.001). ROC curve analysis revealed that the best cut-off value of CTRP3 for the prediction of DSPN was 7.55ng/ml (sensitivity 78.7%, specificity 79.8%), the area under the curve (AUC) was 0.763 (95% CI 0.689-0.838, P < 0.001).
Low serum CTRP3 could be a predictor for the occurrence and progression of DSPN in Chinese patients with T2DM.
远端对称性多发性神经病（DSPN）是2型糖尿病（T2DM）患者最常见的慢性并发症之一。我们之前的研究发现，2型糖尿病患者血清C1q肿瘤坏死因子相关蛋白3（CTRP3）水平降低。因此，本研究旨在揭示血清CTRP3水平降低与DSPN患病率及严重程度之间的关系。
本研究共纳入178例T2DM患者。将受试者分为DSPN组（n = 89）和非DSPN组（n = 89）。记录人体测量参数和神经症状。此外，评估神经体征、神经病变症状评分（NSS）和神经病变残疾评分（NDS）。检测生化指标、空腹胰岛素和C肽。采用酶联免疫吸附测定法（ELISA）检测血清CTRP3浓度。
与非DSPN组相比，DSPN组血清CTRP3水平显著降低（P < 0.05）。CTRP3与DSPN患者的阳性体征数量、NSS评分和NDS评分呈负相关（均P < 0.05）。有趣的是，NSS评分或NDS评分越高，血清CTRP3水平越低（均P < 0.05）。此外，CTRP3水平较低（< 7.58ng/ml）的患者神经体征发生率较高（均P < 0.05）。二元逻辑回归分析显示，CTRP3独立预测DSPN的发生（β = -0.316，P < 0.001）。ROC曲线分析显示，CTRP3预测DSPN的最佳截断值为7.55ng/ml（敏感性78.7%，特异性79.8%），曲线下面积（AUC）为0.763（95%CI 0.689 - 0.838，P < 0.001）。
血清CTRP3水平降低可能是中国T2DM患者DSPN发生和进展的预测指标。
