Frontiers in endocrinology · 2026
Stage-dependent alterations of Sonoclot coagulation profiles across the spectrum of diabetic peripheral neuropathy.
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Zhu Yunqing, Shen Ziyang, Zang Rujin
Аннотация
BACKGROUND: Microvascular hypercoagulability is a primary driver of diabetic peripheral neuropathy (DPN). This study aimed to evaluate comprehensive whole-blood viscoelastic profiles using the Sonoclot analyzer across distinct clinical stages of DPN.
METHODS: This cross-sectional study consecutively enrolled 289 hospitalized patients with type 2 diabetes mellitus (T2DM). Based on the Toronto Clinical Neuropathy Score (TCNS) and nerve conduction studies, participants were classified into non-DPN, subclinical DPN (sDPN), and confirmed DPN groups. Sonoclot-derived parameters were quantitatively assessed. Multivariable logistic regression, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curve analysis were performed to evaluate diagnostic performance.
RESULTS: Among the 289 participants, 93 (32.2%) were diagnosed with sDPN and 70 (24.2%) with confirmed DPN. CR levels did not differ significantly between the non-DPN and sDPN groups, whereas markedly elevated CR levels were observed in patients with confirmed DPN. After adjustment for age, diabetes duration, HbA1c, BMI, and platelet count, CR remained independently associated with DPN (odds ratio 1.154, 95% CI 1.075-1.239). RCS analysis demonstrated a significant nonlinear association between CR levels and the presence of DPN. ROC analysis identified an optimal CR cutoff value of 31.1 (AUC = 0.729), with a sensitivity of 47.1% and a specificity of 98.9%. The moderate sensitivity suggests limited utility as a standalone screening marker.
CONCLUSION: Sonoclot-derived CR is independently associated with clinically confirmed DPN. Longitudinal studies are required to clarify the temporal nature of this association.
METHODS: This cross-sectional study consecutively enrolled 289 hospitalized patients with type 2 diabetes mellitus (T2DM). Based on the Toronto Clinical Neuropathy Score (TCNS) and nerve conduction studies, participants were classified into non-DPN, subclinical DPN (sDPN), and confirmed DPN groups. Sonoclot-derived parameters were quantitatively assessed. Multivariable logistic regression, restricted cubic spline (RCS) analysis, and receiver operating characteristic (ROC) curve analysis were performed to evaluate diagnostic performance.
RESULTS: Among the 289 participants, 93 (32.2%) were diagnosed with sDPN and 70 (24.2%) with confirmed DPN. CR levels did not differ significantly between the non-DPN and sDPN groups, whereas markedly elevated CR levels were observed in patients with confirmed DPN. After adjustment for age, diabetes duration, HbA1c, BMI, and platelet count, CR remained independently associated with DPN (odds ratio 1.154, 95% CI 1.075-1.239). RCS analysis demonstrated a significant nonlinear association between CR levels and the presence of DPN. ROC analysis identified an optimal CR cutoff value of 31.1 (AUC = 0.729), with a sensitivity of 47.1% and a specificity of 98.9%. The moderate sensitivity suggests limited utility as a standalone screening marker.
CONCLUSION: Sonoclot-derived CR is independently associated with clinically confirmed DPN. Longitudinal studies are required to clarify the temporal nature of this association.