Association between serum Sestrin2 level and diabetic peripheral neuropathy in type 2 diabetic patients

BACKGROUND Diabetic peripheral neuropathy(DPN) is a chronic and serious microvascular complication of diabetes linked to redox imbalance. Sestrin2, a novel inducible stress protein, participates in glucose metabolic regulation and redox homeostasis. However, the association between serum Sestrin2 and DPN is unknown.AIM To explore the association between serum Sestrin2 and DPN in patients with type 2 diabetes mellitus(T2DM).METHODS A total of 96 T2DM patients and 39 healthy volunteers, matched by age and sex, participated in this cross-sectional study. Clinical features and metabolic indices were identified. Serum Sestrin2 was measured by ELISA. The association between Sestrin2 and DPN was studied. Correlation and logistic regression analyses were used to evaluate the associations of different metabolic indices with Sestrin2 and DPN.RESULTS The 96 patients with T2DM were divided into DPN(n = 47) and patients without DPN(n = 49). Serum Sestrin2 was significantly lower in healthy volunteers than in all T2DM patients combined [9.10(5.41-13.53) ng/m L vs 12.75(7.44-23.80) ng/m L, P < 0.01]. T2DM patients without DPN also had significantly higher levels of Sestrin2 than healthy volunteers [14.58(7.93-26.62) ng/m L vs 9.10(5.41-13.53) ng/m L, P < 0.01]. However, T2DM patients with DPN had lower circulating Sestrin2 levels compared to T2DM patients without DPN [9.86(6.72-21.71) ng/m L vs 14.58(7.93-26.62) ng/m L, respectively, P < 0.01]. Bivariate correlation analysis revealed that serum Sestrin2 was positively correlated with body mass index(r = 0.672, P = 0.000), hemoglobin A1c(HbA1c)(r = 0.292, P = 0.000), serum creatinine(r = 0.206, P = 0.016), triglycerides(r = 0.731, P = 0.000), and fasting glucose(r = 0.202, P = 0.040), and negatively associated with estimated glomerular filtration rate(r =-0.230, P = 0.007). After adjustment for sex, age, HbA1c, and diabetes duration, multiple regression analysis revealed that Sestrin2 was independently correlated with body mass index and triglyceride levels(P = 0.000). Logistic regression analyses indicated that Sestrin2, diabetes duration, and high-density lipoprotein were strongly associated with DPN(odds ratio = 0.855, 1.411, and 0.041, respectively).CONCLUSION Our results show Sestrin2 is decreased in T2DM patients with DNP. As lower Sestrin2 is independently associated with DPN, Sestrin2 may contribute to progression of DPN in T2DM patients.