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      Diagnostic biomarker for type 2 diabetic peripheral neuropathy via comprehensive bioinformatics analysis

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          Abstract

          Background

          Diabetic peripheral neuropathy (DPN) is a common complication of Type 2 diabetes mellitus (T2DM), which frequently results in disabling neuropathic pain and lower‐limb amputation. The identification of noninvasive biomarkers for DPN may help early detection and individualized treatment of DPN.

          Methods

          In this study, we identified differentially expressed genes (DEGs) between DPN and the control based on blood‐source (GSE95849) and tissue‐source gene expression profiles (GSE143979) from the Gene Expression Omnibus (GEO) database using limma, edgeR, and DESeq2 approaches. KEGGG and GO functional enrichments were performed. Hub genes and their correlation with infiltrating immune cells were analyzed. Real‐time quantitative polymerase chain reaction (RT‐qPCR) was used to quantify hub gene expression.

          Results

          In total, 144 DEGs between DPN and the control were identified. Functional enrichment revealed that the DEGs were mainly enriched in immune‐related pathways like the Fc epsilon receptor Ig signaling pathway. By protein–protein interaction (PPI) network analysis, FCER1G, SYK, ITGA4, F13A1, MS4A2, and PTK2B were screened as hub genes with higher expression in DPN patients, among which half were immune genes ( FCER1G, PTK2B, and SYK). RT‐qPCR demonstrated that mRNA expression of FCER1G, PTK2B, and SYK was significantly increased in patients with DPN compared with both diabetic nonperipheral neuropathy (DNN) and normal subjects. The area under the receiver operating characteristic (ROC) curve of FCER1G, PTK2B, and SYK was 0.84, 0.81, and 0.73, respectively, suggesting their great advantages as diagnostic biomarkers to predict the progression of neuropathy in T2DM. Further analysis indicated that the expression of FCER1G, PTK2B, and SYK was negatively correlated with the cell proportion of significantly altered resting natural killer cells, T follicular helper cells, and activated mast cells, but positively correlated with monocytes.

          Conclusions

          Our findings demonstrated FCER1G, PTK2B, and SYK are potential diagnostic biomarkers and therapeutic targets for DPN, which provides new insight into DPN pathogenesis and therapies.

          Abstract

          Highlights

          • Differentially expressed genes between diabetic peripheral neuropathy (DPN) and normal controls are mainly enriched in immune‐related pathways.

          • Three immune genes— FCER1G, PTK2B, and SYK—were identified as diagnostic and prognostic biomarkers for DPN.

          • Gene expression of FCER1G, PTK2B, and SYK was negatively correlated with the cell proportion of resting natural killer cells, T follicular helper cells, and activated mast cells, but positively correlated with monocytes.

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          Most cited references46

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          WITHDRAWN: Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition

          To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045.
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            Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study.

            Results of intervention studies in patients with type 2 diabetes have led to concerns about the safety of aiming for normal blood glucose concentrations. We assessed survival as a function of HbA(1c) in people with type 2 diabetes. Two cohorts of patients aged 50 years and older with type 2 diabetes were generated from the UK General Practice Research Database from November 1986 to November 2008. We identified 27 965 patients whose treatment had been intensified from oral monotherapy to combination therapy with oral blood-glucose lowering agents, and 20 005 who had changed to regimens that included insulin. Those with diabetes secondary to other causes were excluded. All-cause mortality was the primary outcome. Age, sex, smoking status, cholesterol, cardiovascular risk, and general morbidity were identified as important confounding factors, and Cox survival models were adjusted for these factors accordingly. For combined cohorts, compared with the glycated haemoglobin (HbA(1c)) decile with the lowest hazard (median HbA(1c) 7.5%, IQR 7.5-7.6%), the adjusted hazard ratio (HR) of all-cause mortality in the lowest HbA(1c) decile (6.4%, 6.1-6.6) was 1.52 (95% CI 1.32-1.76), and in the highest HbA(1c) decile (median 10.5%, IQR 10.1-11.2%) was 1.79 (95% CI 1.56-2.06). Results showed a general U-shaped association, with the lowest HR at an HbA(1c) of about 7.5%. HR for all-cause mortality in people given insulin-based regimens (2834 deaths) versus those given combination oral agents (2035) was 1.49 (95% CI 1.39-1.59). Low and high mean HbA(1c) values were associated with increased all-cause mortality and cardiac events. If confirmed, diabetes guidelines might need revision to include a minimum HbA(1c) value. Eli Lilly and Company. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention

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                Author and article information

                Contributors
                yly20070567@126.com
                huibinhuang@fjmu.edu.cn
                Journal
                J Diabetes
                J Diabetes
                10.1111/(ISSN)1753-0407
                JDB
                Journal of Diabetes
                Wiley Publishing Asia Pty Ltd (Melbourne )
                1753-0393
                1753-0407
                29 November 2023
                March 2024
                : 16
                : 3 ( doiID: 10.1111/jdb.v16.3 )
                : e13506
                Affiliations
                [ 1 ] Department of Endocrinology The Second Affiliated Hospital of Fujian Medical University Quanzhou China
                [ 2 ] Department of Cardiology The Second Affiliated Hospital of Fujian Medical University Quanzhou China
                [ 3 ] Central Laboratory The Second Affiliated Hospital of Fujian Medical University Quanzhou China
                Author notes
                [*] [* ] Correspondence

                Liying Yu, Central Laboratory, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China.

                Email: yly20070567@ 123456126.com

                Huibin Huang, Department of Endocrinology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China.

                Email: huibinhuang@ 123456fjmu.edu.cn

                Author information
                https://orcid.org/0000-0002-0404-2385
                Article
                JDB13506
                10.1111/1753-0407.13506
                10925884
                38018513
                50edc509-f5b7-459b-891f-019ab7c5d108
                © 2023 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 September 2023
                : 19 October 2022
                : 08 November 2023
                Page count
                Figures: 8, Tables: 0, Pages: 11, Words: 6376
                Funding
                Funded by: Fujian Provincial Health and Health Scientific Research Talent Training
                Award ID: 2019‐ZQN‐66
                Funded by: Fujian Quanzhou Science and Technology Plan
                Award ID: 2020N035s
                Funded by: Natural Science Foundation of Fujian Province , doi 10.13039/501100003392;
                Award ID: 2022J01279
                Funded by: the doctoral research project of Second Affiliated Hospital of Fujian Medical University
                Award ID: BS202203
                Award ID: 2022BD0704
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                March 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.9 mode:remove_FC converted:11.03.2024

                Endocrinology & Diabetes
                bioinformatic analysis,immune gene,immune infiltration,peripheral neuropathy,type 2 diabetes

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