Plasma neurofilament light chain concentrations are elevated in youth-onset type 2 diabetes and associated with neuropathy.
Plasma neurofilament light chain concentrations are elevated in youth-onset type 2 diabetes and associated with neuropathy.
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青年发病的 2 型糖尿病患者血浆神经丝轻链浓度升高，并与神经病变相关。
DOI：
10.1111/jns.12575
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Reusch,JaneEB
中科院分区：
文献类型：
--
作者：
Fridman,Vera;Sillau,Stefan;Ritchie,Alanna;Bockhorst,Jacob;Coughlan,Christina;Araya,Paula;Espinosa,JoaquinM;Smith,Keith;Lange,EthanM;Lange,LeslieA;Ghormli,LaureEl;Drews,KimberlyL;Zeitler,Philip;Reusch,JaneEB
背景和目标缺乏易于测量的生物标志物仍然是执行糖尿病神经病变（DN）临床试验的一个挑战。血浆神经丝轻链 (NFL) 浓度是免疫介导的神经病的一个有前途的生物标志物。尚未进行评估 DN 中 NFL 的纵向研究。方法对参加青少年和青年 2 型糖尿病前瞻性治疗方案 (TODAY) 研究的青年发病 2 型糖尿病参与者进行了巢式病例对照研究。从 2008 年到 2020 年，每 4 年测量一次 50 名患有 DN 的参与者和 50 名未患 DN 的 2 型糖尿病参与者的血浆 NFL 浓度。结果在第一次评估时，DN 组和无 DN 组的 NFL 浓度相似。在所有后续评估期间，DN 参与者的浓度均较高 (allp< .01)。两组的 NFL 浓度随着时间的推移而增加，DN 参与者的变化程度更大（交互作用 p= .045）。在评估 2 时，无 DN 患者的 NFL 值加倍，最终 DN 结果的几率增加了 2.86 的估计比率（95% CI：[1.30, 6.33]，p= .0046）。在最后一次研究访视时，观察到 NFL 与 HbA1c (0.48，p< .0001)、总胆固醇 (0.25，p= .018) 和低密度脂蛋白 (LDL (0.30，p= .0037)) 之间存在 Spearman 正相关性（控制年龄、性别、糖尿病病程和 BMI）。观察到与心率变异性测量呈负相关（-0.42 至 -0.46，p= <.0001）。 解释 研究发现，青少年发病的 2 型糖尿病患者中 NFL 浓度升高，而 DN 患者中升高得更快，这表明 NFL 可能是 DN 的一个有价值的生物标志物。
Background and AimsThe lack of easily measurable biomarkers remains a challenge in executing clinical trials for diabetic neuropathy (DN). Plasma Neurofilament light chain (NFL) concentration is a promising biomarker in immune‐mediated neuropathies. Longitudinal studies evaluating NFL in DN have not been performed.MethodsA nested case–control study was performed on participants with youth‐onset type 2 diabetes enrolled in the prospective Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) study. Plasma NFL concentrations were measured at 4‐year intervals from 2008 to 2020 in 50 participants who developed DN and 50 participants with type 2 diabetes who did not develop DN.ResultsNFL concentrations were similar in the DN and no DN groups at the first assessment. Concentrations were higher in DN participants at all subsequent assessment periods (allp< .01). NFL concentrations increased over time in both groups, with higher degrees of change in DN participants (interactionp= .045). A doubling of the NFL value at Assessment 2 in those without DN increased the odds of ultimate DN outcome by an estimated ratio of 2.86 (95% CI: [1.30, 6.33],p= .0046). At the final study visit, positive Spearman correlations (controlled for age, sex, diabetes duration, and BMI) were observed between NFL and HbA1c (0.48,p< .0001), total cholesterol (0.25,p= .018), and low‐density lipoprotein (LDL (0.30,p= .0037)). Negative correlations were observed with measures of heart rate variability (−0.42 to −0.46,p= <.0001).InterpretationThe findings that NFL concentrations are elevated in individuals with youth‐onset type 2 diabetes, and increase more rapidly in those who develop DN, suggest that NFL could be a valuable biomarker for DN.
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DOI：
10.1016/s0021-9258(18)61070-1
发表时间：
1987-07
期刊：
The Journal of biological chemistry
影响因子：
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1989-09
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10.1016/s0021-9258(18)68111-6
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1988-10
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