中国实用神经疾病杂志2025，Vol.28Issue(6)：731-735,5.DOI:10.12083/SYSJ.240382
NTN4基因甲基化对硫辛酸联合依帕司他治疗糖尿病周围神经病变效果的影响
Impact of NTN4 gene methylation on the effect of lipoic acid combined with epalrestat in the treatment of diabetic peripheral neuropathy
摘要
Abstract
Objective To investigate the impact of NTN4 gene methylation on the therapeutic efficacy of lipoic acid combined with epalrestat for diabetic peripheral neuropathy(DPN).Methods A total of 102 DPN patients admitted to the Chongqing Armed Police Corps Hospital from January 2021 to January 2023 were selected as the study objects.All patients received lipoic acid combined with epalrestat.According to the DPN diagnosis and treatment guidelines,the comprehensive efficacy was evaluated and the patients were divided into treatment ineffective group and treatment effective group.Methylation-specific PCR(MS-PCR)and unmethylation-specific PCR(UMS-PCR)methods were used to detect the methylation level of NTN4 gene in the peripheral blood of the two groups and were compared.Nerve conduction velocity was measured using electromyogram to compare the nerve conduction velocity of the two groups,and the correlation between NTN4 gene methylation and nerve conduction velocity was analyzed.The predictive value of NTN4 gene methylation level for the efficacy of alpha lipoic acid combined with pregabalin in treating DPN was also analyzed.Results The overall effective rate of treatment was 69.6%(71/102),with 71 patients in the treatment effective group and 31 patients in the treatment ineffective group.There were no statistically significant differences in NTN4 gene methylation levels and nerve conduction velocity between the two groups before treatment(P>0.05).After treatment,NTN4 gene methylation levels in the treatment effective group were significantly lower than those in the treatment ineffective group,and the nerve conduction velocity was significantly higher than that in the treatment ineffective group,with statistically significant differences(P<0.05).NTN4 gene methylation levels were significantly negatively correlated to nerve conduction velocity in both groups(P<0.05).ROC curve analysis showed that area under the curve(AUC)value of NTN4 gene methylation levels between the treatment effective group and the treatment ineffective group was 0.85(P<0.05).Conclusion After treatment with sulforaphane combined with ipatasertib,the methylation level of NTN4 gene in the patients with DPN significantly decreases.The methylation level of NTN4 gene can be used as a biomarker to predict the therapeutic effect of sulforaphane combined with ipatasertib in treating DPN.关键词
糖尿病周围神经病变/2型糖尿病/硫辛酸/依帕司他/NTN4基因/基因甲基化Key words
Diabetic peripheral neuropathy/Type 2 diabetes mellitus/Lipoic acid/Epalrestat/NTN4 gene/Gene methylation分类
医药卫生引用本文复制引用
谭谡,古中建,丁秋,李培,胡雪,温辉..NTN4基因甲基化对硫辛酸联合依帕司他治疗糖尿病周围神经病变效果的影响[J].中国实用神经疾病杂志,2025,28(6):731-735,5.基金项目
重庆市南岸区科卫联合医学科研项目(编号:2023-04) （编号:2023-04）
