Association of TNFSF14 with carotid intima-media thickness in newly diagnosed type 2 diabetes: a comparison of older and younger adults

Introduction: Tumor necrosis factor superfamily member 14 (TNFSF14) is an immuno-inflammatory biomarker which might play a role in the pathogenesis of type-2 Diabetes Mellitus (T2DM) and also vascular inflammation. Carotid intima-media thickness (CIMT) is a marker of vascular risk and is a well-established marker of subclinical atherosclerosis; however, data on its relationship with TNFSF14, particularly in newly diagnosed T2DM patients, remain limited. Our aim was to investigate the association between TNFSF14 and CIMT in patients with newly diagnosed T2DM and to evaluate whether these markers could serve as supportive indicators for T2DM, including age-based comparison between adult and older patient groups.Methods: This cross-sectional study was conducted at the Internal Medicine Outpatient Clinics of a tertiary hospital. Newly diagnosed T2DM patients and controls without DM were included in the study. Biochemical parameters, TNFSF14 levels and CIMT were measured. Serum TNFSF14 levels were measured using enzyme-linked immunosorbent assay (ELISA), and CIMT was assessed by B-mode ultrasonography. Statistical analyses were performed to determine correlations between TNFSF14, CIMT, and metabolic parameters, and receiver operating characteristic (ROC) analysis was used to evaluate diagnostic performance. Data were assessed in whole group and according to age groups (≥50<years).Results: 79 patients with T2DM and 90 patients without DM were included in the study. TNFSF14, and CIMT levels were significantly higher in patients with T2DM than control group patients (p<0.001). TNFSF14 was positively correlated with CIMT (p<0.001) and showed strong diagnostic performance with an AUC of 0.90 (95%CI, 0.85-0.95, p<0.001) for presence of T2DM. Optimal cut-off value of TNFSF14 for discriminating T2DM was 57.60, 91% sensitivity, 82% specificity. TNFSF14 also showed strong diagnostic performance in both older and adult patient groups as well. CIMT showed moderate diagnostic value for diabetes overall and in those aged 50+, but with poor specificity.Conclusions: CIMT and especially circulating TNFSF14 with a high sensitivity and specificity might be used as supportive markers for T2DM, regardless of age.