Fibrinogen function indexes are potential biomarkers of diabetic peripheral neuropathy

Abstract

Background and objectives Research suggests that diabetic peripheral neuropathy (DPN) is related to plasma fibrinogen (Fib) concentrations, although its correlation with Fib function has not been reported. Here, the k value and angle α, reflecting the plasma Fib function, were used to analyse its correlation with DPN, and their potential as biological indicators for diagnosing DPN was explored. Subjects and methods This prospective observational clinical study enrolled 561 type 2 diabetes mellitus (T2DM) patients, who were divided into the diabetes with symptomatic neuropathy (161 cases), diabetes with asymptomatic neuropathy (132 cases) and diabetes with no neuropathy (268 cases) groups. Meanwhile, 160 healthy unrelated subjects were recruited as controls. Results Fib levels increased slightly in diabetic subjects with neuropathy compared with those without. The angle α levels increased slightly in subjects with asymptomatic DPN compared with those with no neuropathy and increased greatly in subjects with symptomatic DPN compared with those without. The k value levels slightly decreased in subjects with asymptomatic DPN compared with those with no neuropathy and greatly decreased in subjects with symptomatic DPN compared with those without. The association of the k value and angle α with diabetic neuropathy was independent of the hyperglycaemic state and other potential confounders (odds ratio 0.080 [0.051–0.124], P < 0.001; odds ratio 1.131 [1.063–1.204], P < 0.001). The k value and angle α levels were closely correlated with neuropathy stage (r = − 0.686, P < 0.000; r = 0.314, P < 0.001). The optimal cut-off point for k value levels to distinguish patients with diabetic neuropathy from those without was 1.8 min, with a sensitivity of 73.7% and a specificity of 83.2% (AUC = 0.873). The optimal cut-off point for angle α levels was 60°, with a sensitivity of 41.0% and a specificity of 95.6% (AUC = 0.669). Conclusions The k value and angle α are closely associated with DPN. The levels of the k value and angle α may be helpful in the early diagnosis of DPN.

The predictive value of fibrinogen in the occurrence of mild cognitive impairment events in patients with diabetic peripheral neuropathy

“…In addition, DPN is known to be associated with oxidative stress, immune, metabolic abnormalities and inflammatory responses [10]. We have confirmed that Fib and DPN are closely related [11]. The correlation between DPN and Fib has also been confirmed in several studies [12][13][14].…”

“…A total of 207 subjects who met the 1999 World Health Organization (WHO) type 2 diabetes diagnostic criteria and were registered consecutively as inpatients or outpatients with our hospital between March 2018 and March 2019 were randomly enrolled in this study [ 11 ]. And 90 healthy subjects were randomly included as a control group.…”

“…All patients underwent a physical examination and had a complete history of neurological symptoms. All participants were examined using electromyography (EMG) instrument (Keypoint 9033A07, Denmark) [ 11 ].…”

Increased plasma D-dimer levels may be a promising indicator for diabetic peripheral neuropathy in type 2 diabetes

“…Finally, we used receiver operating characteristic (ROC) curves to assess the diagnostic capability of plasma D-dimer to confirm DPN and to determine the optimal cutoff value of plasma D-dimer to discriminate DPN. HbA1c and plasma fibrinogen were wellestablished risk factors for DPN in our previous studies and other previous studies (21,25,26). To explore whether the predictive ability of plasma D-dimer is beyond traditional risk factors, we set a reference model including age, sex, diabetes duration, BMI, SBP, DBP, hypertension, statin treatment, ALT, lipid profiles, UA, eGFR, fasting C-peptide, fasting glucagon, PT, APTT, and antidiabetic treatments.…”

“…Alongside an excessive glucose burden, a hypercoagulability state was also found to take part in the vascular complications of diabetes ( 33 ). As a coagulation factor, an increased level of plasma fibrinogen was revealed to be closely related to DPN ( 26 ). In our present study, plasma D-dimer, a degradation product of fibrinogen, was found to be associated with DPN.…”