Ahrițculesei Roxana-Viorela, Boldeanu Lidia, Caragea Daniel Cosmin, Vladu Ionela Mihaela, Clenciu Diana, Mitrea Adina, Ungureanu Anca Marilena, Văduva Constantin-Cristian, Dijmărescu Anda Lorena, Popescu Alin Iulian Silviu, Assani Mohamed-Zakaria, Boldeanu Mihail Virgil, Vere Cristin Constantin
Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Microbiology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Int J Mol Sci. 2025 Apr 12;26(8):3661. doi: 10.3390/ijms26083661.
Systemic inflammation has an important role in the prognosis and progression of many chronic diseases, including diabetes (T2DM). This retrospective study aimed to evaluate inflammatory status by determining the serum inflammatory biomarkers (PTX3, hs-CRP, TNF-α, and IL-6) and new indices, like the mean corpuscular volume (MCV) to lymphocyte ratio (MCVL) and cumulative inflammatory index (IIC), in a cohort of patients with prediabetes (PreDM) and newly diagnosed T2DM. We also wanted to assess the association with clinical parameters and different obesity-related indices, to identify possible correlations and to evaluate the diagnostic accuracy of the biomarkers using ROC curve analysis. In this study, we included 60 patients diagnosed with T2DM and 30 patients with PreDM. The ELISA method was applied. Elevated PTX3, hs-CRP, TNF-α, and IL-6 levels were found in T2DM patients compared to preDM patients. An independent relationship was found between PTX3, hs-CRP, and different obesity-related indices in patients with preDM and T2DM. The MCVL index exhibited an inverse trend proportional to the rising levels of HbA1c in the T2DM group. Spearman's analysis revealed in the T2DM group that the PTX3 values correlated much better with IIC (rho = 0.445, -value = 0.014) and MCVL (rho = 0.338, -value = 0.048). Hs-CRP values expressed moderate-to-weak correlations with IIC and MCVL in both groups. Additionally, ROC analysis showed that the PTX3 (AUC was 0.720; = 0.003; cut-off value 1888.00 pg/mL, with 67.60% sensitivity and 73.30% specificity) and MCVL index (AUC was 0.677; = 0.047; cut-off value 39.60, with 63.30% sensitivity and 66.70% specificity) have a good, accurate diagnosis compared with IL-6 (AUC was 0.866; < 0.0001; cut-off value 40.30 pg/mL, with 100.00% sensitivity and 60.00% specificity). IIC showed 61.70% sensitivity and 60.00% specificity, with an AUC of 0.572, = 0.027 and a cut-off value of 2.35. PTX3 and MCVL can serve as independent predictor factors in the inflammatory status in preDM and T2DM patients, supporting their potential as biomarkers for T2DM management and future research.
全身炎症在包括糖尿病（2型糖尿病，T2DM）在内的许多慢性疾病的预后和进展中起着重要作用。这项回顾性研究旨在通过测定血清炎症生物标志物（PTX3、超敏C反应蛋白、肿瘤坏死因子-α和白细胞介素-6）以及新指标，如平均红细胞体积（MCV）与淋巴细胞比值（MCVL）和累积炎症指数（IIC），来评估一组糖尿病前期（PreDM）和新诊断的2型糖尿病患者的炎症状态。我们还想评估其与临床参数和不同肥胖相关指标的关联，以确定可能的相关性，并使用受试者工作特征（ROC）曲线分析评估生物标志物的诊断准确性。在本研究中，我们纳入了60例诊断为2型糖尿病的患者和30例糖尿病前期患者。采用酶联免疫吸附测定（ELISA）方法。与糖尿病前期患者相比，2型糖尿病患者的PTX3、超敏C反应蛋白、肿瘤坏死因子-α和白细胞介素-6水平升高。在糖尿病前期和2型糖尿病患者中，发现PTX3、超敏C反应蛋白与不同肥胖相关指标之间存在独立关系。在2型糖尿病组中，MCVL指数呈现出与糖化血红蛋白（HbA1c）水平升高成反比的趋势。Spearman分析显示，在2型糖尿病组中，PTX3值与IIC（rho = 0.445，P值 = 0.014）和MCVL（rho = 0.338，P值 = 0.048）的相关性更好。在两组中，超敏C反应蛋白值与IIC和MCVL均呈中度至弱相关性。此外，ROC分析表明，与白细胞介素-6（AUC为0.866，P < 0.0001；临界值40.30 pg/mL，敏感性为100.00%，特异性为60.00%）相比，PTX3（AUC为0.720，P = 0.003；临界值1888.00 pg/mL，敏感性为67.60%，特异性为73.30%）和MCVL指数（AUC为0.677，P = 0.047；临界值39.60，敏感性为63.30%，特异性为66.70%）具有良好、准确的诊断价值。IIC的敏感性为61.70%，特异性为60.00%，AUC为0.572，P = 0.027，临界值为2.35。PTX3和MCVL可作为糖尿病前期和2型糖尿病患者炎症状态的独立预测因素，支持它们作为2型糖尿病管理和未来研究生物标志物的潜力。
