Serum Sirt1 and METTL3 levels in relation to clinical staging and prognosis of patients with diabetic foot

Ding Yang; Zhang Xiaoli; Sun Guobin; Gong Jingjing; Liu Jinyi; Li Jun; Li Peiling

doi:10.3969/j.issn.1671-6450.2026.03.003

Abstract：Objective To investigate the relationship between serum sirtuin 1(Sirt1)and methyltransferase-like 3(METTL3)levels and the clinical staging and prognosis of patients with diabetic foot(DF).Methods A total of 206 DF pa-tients admitted to the Department of Burns and Plastic Surgery of Ningxia Hui Autonomous Region People's Hospital from January 2023 to January 2025 were prospectively selected as the DF group.Additionally,103 healthy individuals during the same period were selected as the healthy control group in a 2∶1 ratio.Serum levels of Sirt1 and METTL3 were measured using enzyme-linked immunosorbent assay.DF patients were classified into grades 0(n=39),1(n=36),2(n=42),3(n=51),and 4(n=38)based on clinical grading.Spearman correlation analysis was used to assess the correlation between serum Sirt1,METTL3 levels and clinical grade in DF patients.Based on 6-month prognosis,DF patients were divided into poor and good prognosis subgroups.Factors influencing prognosis and the predictive value of serum Sirt1 and METTL3 levels were analyzed.Results Compared with the control group,serum Sirt1 and METTL3 levels were significantly lower in the DF group(t=12.188,14.765,both P＜0.001).Serum Sirt1 and METTL3 levels progressively decreased from grade 0 to grade 4(F=1607.455,2264.970,both P＜0.001).In DF patients,serum Sirt1 was positively correlated with METTL3,while both were neg-atively correlated with clinical grade(r=0.719,-0.774,-0.723,all P＜0.001).The poor prognosis rate among the 206 DF pa-tients was 34.95％(72/206).Prolonged duration of diabetes,clinical grade 4,and elevated glycated hemoglobin(HbA1c)were identified as independent risk factors for poor prognosis in DF patients,while higher Sirt1 and higher METTL3 levels were in-dependent protective factors[OR(95％CI)=1.259(1.062-1.492),8.413(2.230-31.746),2.549(1.443-4.502),0.598(0.472-0.757),0.757(0.677-0.848)].The area under the ROC curve(AUC)for predicting poor prognosis in DF patients using serum Sirt1 level,METTL3 level,and their combination were 0.805,0.796,and 0.892,respectively.The combined prediction of Sirt1 and METTL3 showed greater value for predicting poor prognosis in DF patients than either biomarker alone(Z=3.594,3.580,both P＜0.001).Conclusion Decreased serum levels of Sirt1 and METTL3 are associated with increased clinical grade and poor prognosis in DF patients.The combination of serum Sirt1 and METTL3 levels demonstrates high efficacy in predicting prognosis.