{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:43:12Z","timestamp":1785789792609,"version":"3.56.0"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The diagnosis of diabetic peripheral neuropathy (DPN) remains challenging because of the lack of objective biomarkers. In this study, we explored the niacin\u2010induced skin flushing response (NSFR) as a novel diagnostic biomarker for DPN on the basis of its association with microangiopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We recruited 114 patients with type 2 diabetes (51 with DPN, 59 without DPN, and 4 with unclear neuropathy status) and 91 healthy controls. Peripheral neuropathy was assessed through clinical symptoms and signs, vibration threshold testing and electromyography. NSFR was measured using a six\u2010chamber sandwich patch and six concentrations of aqueous methyl nicotinate. Demographic and clinical data were collected via questionnaires and medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The NSFR was significantly lower in patients with type 2 diabetes than in healthy controls (1613\u00a0\u00b1\u00a01130.1 vs. 2494.6\u00a0\u00b1\u00a01071.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and was further reduced in DPN patients than in those without DPN (1105.4\u00a0\u00b1\u00a0950.93 vs. 2063.7\u00a0\u00b1\u00a01119.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). The association between the NSFR and the risk of developing DPN remained significant after adjusting for potential confounding factors (OR 0.848, 95% CI 0.757\u20130.949;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.004). A nomogram illustrated the role of the NSFR in predicting DPN occurrence. The ROC curve for the NSFR had an AUC of 0.740, with 72.55% sensitivity and 66.10% specificity. For the combined model, the AUC improved to 0.898, with 89.58% sensitivity and 78.85% specificity. Decision curve analysis confirmed the practical clinical value of the NSFR for predicting DPN risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NSFR is significantly associated with the risk of developing peripheral neuropathy in diabetic patients and shows promise as a diagnostic tool for DPN.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70042","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T08:20:04Z","timestamp":1745569204000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Attenuated Niacin Skin Flushing Response in Diabetic Peripheral Neuropathy Patients: A Novel Clinical Diagnostic Tool"],"prefix":"10.1002","volume":"41","author":[{"given":"Tianyuan","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism School of Medicine Shanghai General Hospital Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dandan","family":"Wang","sequence":"additional","affiliation":[{"name":"Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders Ministry of Education Bio\u2010X Institutes Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruoting","family":"Chai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism School of Medicine Shanghai General Hospital Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyun","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism School of Medicine Shanghai General Hospital Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liying","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism School of Medicine Shanghai General Hospital Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism School of Medicine Shanghai General Hospital Shanghai Jiao Tong University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism School of Medicine Shanghai General Hospital Shanghai Jiao Tong University  Shanghai 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