Abstract
AIMS/INTRODUCTION: Cross-sectional area (CSA) by high-frequency ultrasound (HF-US) detects morphologic changes in neuropathy. microRNA (miR)-92a-3p is linked to diabetes and nerve damage. Our study evaluated the diagnostic use of CSAs along with miR-92a-3p in diabetic peripheral neuropathy (DPN) and its relationship to the condition. MATERIALS AND METHODS: A total of 172 patients were enrolled, comprising 89 with DPN and 83 T2DM cases without DPN. Real-time quantitative polymerase chain reaction (RT-qPCR) was utilized to quantify serum miR-92a-3p levels. HF-US detected CSA in the median, ulnar, and tibial nerves. Logistic regression analyzed potential risk factors for DPN occurrence and severity. Receiver operating characteristic curves assessed the diagnostic significance of miR-92a-3p and CSAs for DPN. Pearson coefficients evaluated the correlation between the Toronto Clinical Scoring System (TCSS) score and miR-92a-3p or CSAs. RESULTS: DPN patients had significantly higher serum miR-92a-3p levels and CSAs of the median, tibial, and ulnar nerves than T2DM patients. Moreover, miR-92a-3p and CSAs were risk factors for DPN. When combined, they yielded an AUC of 0.891, with 80.90% sensitivity and 91.57% specificity, accurately identifying DPN patients. Furthermore, miR-92a-3p and CSAs correlated with TCSS score and were higher in moderate-to-severe patients with DPN than in mild patients with DPN. Finally, miR-92a-3p combined with CSAs predicted moderate-to-severe DPN with 91.67% sensitivity and 85.37% specificity. CONCLUSIONS: Serum miR-92a-3p and CSAs of median, ulnar, and tibial nerves are elevated in DPN patients. Their combination has high diagnostic significance in identifying DPN in T2DM patients and assessing its severity.