Significant decrease of serum extracellular vesicle neuropilin-1 in type 2 diabetes mellitus patients with endothelial dysfunction: a cross-sectional study.

AIMS: To investigate the association between serum extracellular vesicle-derived neuropilin-1 (EV NRP1) and endothelial dysfunction in patients with type 2 diabetes mellitus (T2DM). METHODS: In this cross-sectional study, 164 hospitalized patients with type 2 diabetes mellitus underwent Endo PAT testing and were classified into endothelial dysfunction and normal endothelial function groups according to the reactive hyperemia index (RHI). Serum extracellular vesicles were isolated using a precipitation-based kit. Serum extracellular vesicle-derived neuropilin-1 and serum neuropilin-1 concentrations were measured using a flow cytometric multiplex assay. RESULTS: EV NRP1 levels were significantly lower in the endothelial dysfunction group than in the normal endothelial function group (207.69 ± 142.97 vs. 271.89 ± 174.07 ng/mL, P = 0.015), and serum NRP1 showed a similar decreasing trend (206.10 ± 48.35 vs. 223.22 ± 49.03 ng/mL, P = 0.030). EV NRP1, rather than serum NRP1, was positively correlated with RHI and LnRHI. Higher EV NRP1 was independently associated with lower odds of endothelial dysfunction (OR = 0.627, 95% CI 0.417-0.944; P = 0.025). CONCLUSIONS: EV NRP1 levels are reduced and independently associated with endothelial dysfunction in patients with T2DM, supporting its potential as a biomarker for diabetic endothelial dysfunction.