Association of serum spexin and TSH levels with peripheral neuropathy in euthyroid patients with type 2 diabetes mellitus

doi:10.3969/j.issn.1004-583X.2026.06.008

Abstract

Abstract:

Objective To analyze the association of serum spexin and thyroid-stimulating hormone (TSH) levels with diabetic peripheral neuropathy (DPN) in euthyroid patients with type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was performed on 391 patients with T2DM hospitalized in the Department of Endocrinology of the Fifth Affiliated Hospital of Zhengzhou University from January 2025 to December 2025. Among them, 184 patients with DPN were included in the study group, and 207 patients without DPN were included in the control group. Thyroid function tests were completed in all patients, and the results were normal. Clinical data and biochemical indicators were collected for both groups. Multivariate logistic regression was used to identify risk factors for DPN in patients with T2DM, and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of spexin and TSH for DPN. Results Compared with the control group, the study group had lower body mass index (BMI) and serum spexin levels, and the differences were statistically significant (t=3.671, 6.902, P<0.05). In the study group, diabetes duration, glycated hemoglobin A₁c (HbA₁c), triglycerides (TG), TSH, and homocysteine (Hcy) were all higher than those in the control group, with statistically significant differences (P<0.05). Logistic regression analysis showed that diabetes duration, HbA₁c, TSH, and spexin were independent risk factors for DPN in patients with T2DM (P<0.05). ROC analysis showed that the areas under the curve(AUC) for serum spexin and TSH in predicting DPN in patients with T2DM were 0.685 and 0.713, respectively. The AUC for their combined prediction was 0.749, which was higher than that of either marker alone (P<0.05). Conclusion In euthyroid patients with T2DM, serum spexin and TSH are independent risk factors for DPN. Combined detection of these two markers has certain predictive value for identifying whether T2DM is complicated by DPN.

Key words: diabetes mellitus, type 2, thyroid hormone, diabetic neuropathies, spexin

CLC Number:

R587.1

Tian Xiaofei, Rao Xiaojuan, Shi Shuangwei, Fang Yifan. Association of serum spexin and TSH levels with peripheral neuropathy in euthyroid patients with type 2 diabetes mellitus[J]. Clinical Focus, 2026, 41(6): 529-533.

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URL: https://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2026.06.008

https://www.lchc.cn/EN/Y2026/V41/I6/529

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References 22

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项目	研究组(n=184)	对照组(n=207)	χ²/t值	P值
性别[例(%)]
男女	103(55.97) 81(44.03)	116(56.04) 91(43.96)	0.877	0.682
吸烟史[例(%)]
有无	78(42.39) 106(57.61)	87(42.03) 120(57.97)	0.747	0.604
饮酒史[例(%)]
有无	56(30.43) 128(69.57)	67(32.37) 140(67.63)	1.582	0.792
高血压病史[例(%)]
有无	45(24.45) 139(75.54)	54(26.09) 153(73.91)	1.374	0.839
冠心病病史[例(%)]
有无	38(20.65) 146(79.35)	46(22.22) 161(77.78)	0.975	0.683
年龄(岁)	54.23±2.83	55.61±1.92	0.832	0.581
BMI(kg/m²)	24.63±3.81	26.09±2.74	3.671	0.017
病程(年)	6.72±1.84	5.93±1.30	3.374	0.020
HbA₁c(%)	9.43±0.73	8.84±1.02	5.820	<0.01
TC(mmol/L)	5.06±0.73	5.01±1.04	0.783	0.621
TG(mmol/L)	2.84±0.71	2.31±0.63	3.091	0.008
HDL-C(mmol/L)	1.53±0.17	1.94±0.36	0.904	0.391
LDL-C(mmol/L)	2.47±0.61	2.03±0.59	0.893	0.402
FT3(pmol/L)	4.52±0.93	4.38±0.72	0.594	0.702
FT4(pmol/L)	13.61±2.31	14.78±1.92	0.792	0.571
TSH(mU/L)	2.75±0.27	1.67±0.39	4.782	<0.01
SUA(μmol/L)	324.82±40.92	321.04±51.20	0.582	0.681
Hcy(μmol/L)	16.72±2.05	13.02±2.94	2.943	0.019
血清spexin(μg/L)	0.89±0.20	1.25±0.19	6.902	<0.01

项目	研究组(n=184)	对照组(n=207)	χ²/t值	P值
性别[例(%)]
男女	103(55.97) 81(44.03)	116(56.04) 91(43.96)	0.877	0.682
吸烟史[例(%)]
有无	78(42.39) 106(57.61)	87(42.03) 120(57.97)	0.747	0.604
饮酒史[例(%)]
有无	56(30.43) 128(69.57)	67(32.37) 140(67.63)	1.582	0.792
高血压病史[例(%)]
有无	45(24.45) 139(75.54)	54(26.09) 153(73.91)	1.374	0.839
冠心病病史[例(%)]
有无	38(20.65) 146(79.35)	46(22.22) 161(77.78)	0.975	0.683
年龄(岁)	54.23±2.83	55.61±1.92	0.832	0.581
BMI(kg/m²)	24.63±3.81	26.09±2.74	3.671	0.017
病程(年)	6.72±1.84	5.93±1.30	3.374	0.020
HbA₁c(%)	9.43±0.73	8.84±1.02	5.820	<0.01
TC(mmol/L)	5.06±0.73	5.01±1.04	0.783	0.621
TG(mmol/L)	2.84±0.71	2.31±0.63	3.091	0.008
HDL-C(mmol/L)	1.53±0.17	1.94±0.36	0.904	0.391
LDL-C(mmol/L)	2.47±0.61	2.03±0.59	0.893	0.402
FT3(pmol/L)	4.52±0.93	4.38±0.72	0.594	0.702
FT4(pmol/L)	13.61±2.31	14.78±1.92	0.792	0.571
TSH(mU/L)	2.75±0.27	1.67±0.39	4.782	<0.01
SUA(μmol/L)	324.82±40.92	321.04±51.20	0.582	0.681
Hcy(μmol/L)	16.72±2.05	13.02±2.94	2.943	0.019
血清spexin(μg/L)	0.89±0.20	1.25±0.19	6.902	<0.01

因素	β值	S.E值	Waldχ²值	OR值	95%CI	P值
病程(年)	0.078	0.021	13.629	1.072	1.030~1.115	<0.01
HbA₁c(%)	0.185	0.062	8.045	1.162	1.032~1.329	<0.01
TSH (mU/L)	0.352	0.073	22.405	1.389	1.204~1.526	<0.01
血清spexin (μg/L)	-0.183	0.018	15.824	1.043	0.971~1.203	<0.01

因素	β值	S.E值	Waldχ²值	OR值	95%CI	P值
病程(年)	0.078	0.021	13.629	1.072	1.030~1.115	<0.01
HbA₁c(%)	0.185	0.062	8.045	1.162	1.032~1.329	<0.01
TSH (mU/L)	0.352	0.073	22.405	1.389	1.204~1.526	<0.01
血清spexin (μg/L)	-0.183	0.018	15.824	1.043	0.971~1.203	<0.01

指标	最佳截断值	AUC	95%CI	敏感度	特异度	P值
spexin(μg/L)	1.03	0.685	0.572~0.741	0.642	0.684	<0.01
TSH(mU/L)	2.67	0.713	0.569~0.783	0.628	0.718	0.002
联合检测		0.749	0.592~0.801	0.682	0.739	<0.01