Lin Ke, Wang Xiaocui, Gu Tao, Feng Keduo, Zeng Wang, Yang Liu
Department of Neurology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People's Republic of China.
Department of Endocrinology, Translational Research of Diabetes Key Laboratory of Chongqing Education Commission of China, Second Affiliated Hospital of Army Medical University, Chongqing, People's Republic of China.
Diabetes Metab Syndr Obes. 2025 Mar 13;18:785-793. doi: 10.2147/DMSO.S485853. eCollection 2025.
To assess the plasma concentrations of the novel hepatokine fetuin-B in individuals with type 2 diabetes with or without diabetic peripheral neuropathy (DPN), and to evaluate the relationship among fetuin-B levels, nervous function, and metabolic parameters.
A total of 333 participants were recruited and divided into three groups: DPN, painful DPN (pDPN), and non-DPN. Metabolic parameters, peripheral neuropathy-associated indices, and general biochemical parameters were also measured.
Compared with the non-DPN group, general parameters, including age, SBP, BUN, Cr, and ALT, were significantly higher in the DPN and pDPN groups, and FPG, HbA1c, TC, TG, LDL, BUN, Cr, and UA levels were higher in the pDPN group. The neuropathy symptom score (NSS), neuropathy disability score (NDS), and Douleur Neuropathique en 4 Questions (DN4) were highest in the pDPN group, followed by the DPN group, and lowest in the non-DPN group. Moreover, fetuin B levels showed the same trends as peripheral neuropathy indices. Additionally, oxidative stress markers showed a decrease in total antioxidant capacity (TAC) and an increase in malondialdehyde (MDA) across all groups, with the most pronounced changes observed in pDPN patients. Bivariate correlation analysis showed that fetuin B levels were positively correlated with FPG, TC, LDL, NSS, NDS, DN4, and MDA levels, and negatively associated with TAC after adjusting for age and sex. Furthermore, nerve conduction velocity, including MLT, MRT, SRS, and SLT, showed decreasing trends among tertiles of fetuin B levels.
The current study suggests that circulating fetuin-B levels may be associated with the progression of pDPN and highlights the effects of hepatokine-mediated liver-to-peripheral nervous system crosstalk in DPN.
评估2型糖尿病伴或不伴糖尿病周围神经病变（DPN）患者血浆中新型肝源细胞因子胎球蛋白-B的浓度，并评估胎球蛋白-B水平、神经功能和代谢参数之间的关系。
共招募333名参与者，分为三组：DPN组、疼痛性DPN（pDPN）组和非DPN组。还测量了代谢参数、周围神经病变相关指标和一般生化参数。
与非DPN组相比，DPN组和pDPN组的一般参数，包括年龄、收缩压、尿素氮、肌酐和谷丙转氨酶，显著更高，且pDPN组的空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、低密度脂蛋白、尿素氮、肌酐和尿酸水平更高。神经病变症状评分（NSS）、神经病变残疾评分（NDS）和四问题神经疼痛量表（DN4）在pDPN组最高，其次是DPN组，在非DPN组最低。此外，胎球蛋白B水平与周围神经病变指标呈现相同趋势。此外，氧化应激标志物显示所有组的总抗氧化能力（TAC）降低，丙二醛（MDA）增加，在pDPN患者中观察到的变化最为明显。双变量相关性分析显示，在调整年龄和性别后，胎球蛋白B水平与空腹血糖、总胆固醇、低密度脂蛋白、NSS、NDS、DN4和MDA水平呈正相关，与TAC呈负相关。此外，包括运动神经传导速度（MLT）、感觉神经传导速度（MRT）、感觉反应时（SRS）和感觉潜伏期（SLT）在内的神经传导速度在胎球蛋白B水平三分位数之间呈下降趋势。
当前研究表明，循环胎球蛋白-B水平可能与pDPN的进展相关，并突出了肝源细胞因子介导的肝脏与周围神经系统串扰在DPN中的作用。
