The Correlation between Collagen Conversion Markers and Cardiovascular Autonomic Neuropathy in Patients with Prediabetes

LI Xiaoli; PU Qiang

doi:10.12102/j.issn.1672-1349.2025.17.020

Abstract：Objective: To explore the correlation between collagen turnover markers and cardiac autonomic neuropathy (CAN) in patients with prediabetes. Methods: A total of 182 cases of prediabetic patients screened through physical examinations at the Department of Endocrinology and its medical consortium units of Rugao City Hospital of Traditional Chinese Medicine from January 2021 to June 2023 were selected as the study subjects. According to the results of the Ewing test, the patients were divided into CAN group (62 cases) and non-CAN group (120 cases). The clinical characteristics and influencing factors of CAN were analyzed. Results: The age of patients in the CAN group was lower than that in the non-CAN group (P < 0.05), while body mass index (BMI) and postprandial 2-hour glucose (2 hPG) levels were higher (P < 0.05). The CAN group had lower values of standard deviation of normal-to-normal intervals (SDNN), standard deviation of the averages of normal-to-normal intervals (SDANN), root mean square of successive differences (RMSSD), percentage of pairs of adjacent R-R intervals differing by more than 50 ms (PNN50), low-frequency power (LF), and high-frequency power (HF) compared to the non-CAN group, with statistically significant differences (P < 0.05). The CAN group showed higher levels of the collagen type VI formation marker PRO-C6 and the collagen type III degradation marker C3M compared to the non-CAN group, with statistically significant differences (P < 0.05). Spearman correlation analysis showed that CAN was positively correlated with BMI and 2hPG (P < 0.05), and negatively correlated with age (P < 0.05). Logistic regression analysis showed that serum PRO-C6 and serum C3M were risk factors for CAN. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for serum PRO-C6 in predicting CAN was 0.876, with a sensitivity of 74.2% and specificity of 85.8%. For serum C3M, the AUC was 0.642, with a sensitivity of 53.2% and specificity of 73.3%. Conclusion: Serum PRO-C6 and C3M are risk factors for CAN and have certain predictive value.