Predictive value of combined detection of serum C-peptide,forkhead box O-type transcription factor-3a,and metallothionein for diabetic peripheral neuropathy
10.3969/j.issn.1006-6187.2025.09.003
- VernacularTitle:血清C肽、叉头盒O类转录因子3a、镍纹样蛋白联合检测对糖尿病周围神经病变的预测价值
- Author:
Caining WANG
1
;
Meiliu YANG
;
Wu YU
Author Information
1. 063000 唐山,开滦总医院内分泌科
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus,type 2;
C-peptide;
Forkhead box O-type transcription factor-3a;
Metallothionein;
Diabetes peripheral neuropathy
- From:
Chinese Journal of Diabetes
2025;33(9):651-655
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictive value of combined detection of serum C-peptide(C-P),forkhead box O transcription factor-3a(FOXO3a),and metallothionein(Metrnl)for diabetic peripheral neuropathy(DPN).Methods A total of 210 patients with type 2 diabetes mellitus(T2DM)in Kailuan General Hospital were enrolled in this study from May 2021 to May 2023.All the patients were followed up for 1 year and 4 patients lost follow-up.All the 206 patients were divided into DPN group(n=52)and simple T2DM group(n=154)according to whether they had concurrent DPN.Baseline data,serum C-P,FOXO3a,and Metrnl levels were compared between the two groups.The relationship between serum C-P,FOXO3a,Metrnl levels and DPN was analyzed using point-biserial correlation and Cox regression analysis.The predictive value of serum C-P,FOXO3a,and Metrnl levels for DPN was analyzed using receiver operating characteristic(ROC)curve analysis.Results DM duration,hemoglobin A1c(HbA1c)levels and FOXO3a were higher in the DPN group than in the T2DM group(P<0.05).Serum C-P and Metrnl levels were lower in the DPN group than in the T2DM group(P<0.05).Correlation analysis showed that serum C-P and Metrnl levels were negatively correlated with DPN(P<0.01),while FOXO3a levels were positively correlated with DPN(P<0.01).Cox regression analysis revealed that serum C-P,FOXO3a,and Metrnl were independent factors for DPN,both before and after adjusting DM duration and HbA1c.The area under the curves for predicting DPN using serum C-P,FOXO3a,and Metrnl were 0.773,0.788,and 0.756,respectively.The sensitivities were 75.00%,76.92%,and 76.92%,and the specificities were 70.78%,69.48%,and 67.53%.The AUC for predicting DPN using the combination of the three markers was 0.921,with a sensitivity of 80.77%and a specificity of 90.26%.The combined predictive value was significantly higher than that of each marker alone(Z=3.520,2.969,3.531,all P<0.05).Conclusions Serum C-P,FOXO3a,and Metrnl are independent influencing factors for DPN in T2DM patients,and the combined detection has reliable predictive value.
