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Decreased plasma neuregulin 4 concentration is associated with increased high-sensitivity C-reactive protein in newly diagnosed type 2 diabetes mellitus patients: a cross-sectional study

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Abstract

Aims

Inflammation has been reported to be involved in the pathogenesis of atherosclerosis. This principal objective of this study was to investigate if the secretion of neuregulin 4 (Nrg4), a soluble protein associated with metabolic syndrome and subclinical cardiovascular disease, is correlated with the inflammation marker high-sensitivity C-reactive protein (hs-CRP) in patients with newly diagnosed type 2 diabetes mellitus (nT2DM).

Methods

A study group of 311 nT2DM patients was divided into three subgroups based on hs-CRP tertiles. Multiple linear regression was conducted to explore the association between plasma Nrg4 and hs-CRP levels.

Results

The nT2DM patients with the highest hs-CRP levels (>2.46 mg/L) exhibited higher atherogenic coefficients and atherogenic index of plasma (AIP) levels, but lower levels of plasma Nrg4, as compared to those with the lowest hs-CRP levels (<0.63 mg/L). Plasma Nrg4 levels were inversely associated with white blood cell count, hs-CRP, and AIP and positively associated with high-density lipoprotein cholesterol (HDL-C), before and after adjustment for age, gender, body mass index (BMI), and body fat percentage (P < 0.01 or P < 0.05). hs-CRP was the factor most strongly associated with plasma Nrg4 levels.

Conclusions

These results indicate that lower plasma Nrg4 levels may be associated with elevated hs-CRP in nT2DM patients. It generates the hypothesis that decreased levels of Nrg4 may trigger the development of atherosclerosis through its proinflammatory effects. These findings need to be confirmed by further prospective studies.

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Acknowledgements

We thank all of our colleagues in the clinical laboratory center and endocrine laboratory, and all the nurses in our department for their hard work and valuable assistance with this study. This work was supported by research grants from the National Natural Science Foundation of China (No. 31300946), Sichuan Province Science and Technology Department (Z1448), Health and Family Planning Commission of Sichuan Province (No. 16129), and Luzhou Science and Technology Bureau [No. 2013-S-48 (22/30)].

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Authors and Affiliations

  1. Department of Endocrinology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China

    Pi-Jun Yan, Yong Xu, Qin Wan, Hua Li, Chen-Lin Gao, Jun Yang & Hai-Hua Zhong

  2. Department of Cardiovascular Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China

    Jian Feng

  3. Department of General Medicine, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China

    Zhi-Hong Zhang

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  1. Pi-Jun Yan
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  2. Yong Xu
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Correspondence to Zhi-Hong Zhang.

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The authors have no potential conflicts of interest directly relevant to the contents of this article.

Ethical standard

This study was approved by the Human Research Ethics Committee of the Affiliated Hospital of Southwest Medical University.

Human and animal rights disclosure

The study protocol conformed to the ethical guidelines of the 1975 Declaration of Helsinki.

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Informed consent was obtained from all patients included in the study.

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Yan, PJ., Xu, Y., Wan, Q. et al. Decreased plasma neuregulin 4 concentration is associated with increased high-sensitivity C-reactive protein in newly diagnosed type 2 diabetes mellitus patients: a cross-sectional study. Acta Diabetol 54, 1091–1099 (2017). https://doi.org/10.1007/s00592-017-1044-4

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  • DOI: https://doi.org/10.1007/s00592-017-1044-4

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