Objective To investigate the correlation between serum endothelial cell-specific molecule 1(ESM1),dehydroepiandrosterone sulfate(DHEA-S)and cardiac autonomic neuropathy(CAN)in patients with type 2 diabetes mellitus(T2DM).Methods From August 2021 to August 2023,198 T2DM patients who were diagnosed and treated in Beijing Electric Power Hospital were enrolled.They were classified into CAN group(96 cases)and non-CAN group(102 cases)based on the standard cardiovascular autonomic reflex test(CART).The clinical data of all patients were collected.Serum ESM1,DHEA-S,inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),interleukin-17(IL-17)]and routine biochemical indicators[total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),serum creatinine(SCr),fasting blood glucose,glycated hemoglobin A1c(HbA1c),albumin(Alb),homocysteine(Hcy),cardiac troponin T(cTnT),hemoglobin(Hb)]were determined.Logistic regression analysis was used to evaluate the influencing factors of CAN in T2DM patients.The diagnostic efficacy of serum ESM1 and DHEA-S for CAN in T2DM patients was evaluated by receiver operating characteristic(ROC)curve.Results The serum ESM1 level in CAN group was higher than that in non-CAN group(P＜0.05),and the serum DHEA-S level was lower than that in non-CAN group(P＜0.05).ESM1,HbA1c,hs-CRP and cTnT were the risk factors for CAN in T2DM patients[odds ratios(OR)were 1.584,1.799,1.391 and 1.679,95%confidence intervals(CI)were 1.023-2.452,1.087-2.977,1.013-1.911 and 1.027-2.746,respectively,P＜0.05].DHEA-S and Alb were protective factors for CAN in T2DM patients(OR=0.793 and 0.907,95%CI 0.694-0.906 and 0.849-0.970,respectively,P＜0.05).The areas under curves(AUC)of serum ESM1 and DHEA-S single and combined determinations for the diagnosis of CAN in T2DM patients were 0.889,0.848 and 0.947,respectively.The sensitivity and specificity of the combined determination were 90.6%and 76.4%,respectively.Conclusions Serum ESM1 and DHEA-S may serve as biomarkers for the diagnosis of CAN in patients with T2DM.
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