ArticleArchives of endocrinology and metabolism2026
Evaluating procollagen type III N-terminal propeptide (P3NP) as a biomarker of sarcopenia in women with type 2 diabetes: a cross-sectional study.
Article in Archives of endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo determine whether circulating procollagen type III N-terminal propeptide (P3NP) improves the diagnosis of dual-energy X-ray absorptiometry (DXA)-defined sarcopenia in women with type 2 diabetes mellitus (T2DM). SUBJECTS AND
methodsThis cross-sectional study enrolled 99 women with T2DM who underwent standardized clinical assessment, handgrip strength testing, and whole-body DXA. Sarcopenia was defined using a DXA-derived fat-free mass index. Multivariable logistic regression models included age, body mass index, glycated hemoglobin (HbA1c), and estimated glomerular filtration rate, with and without log-transformed, z-standardized P3NP. Discriminatory performance was quantified by the area under the curve (AUC) with bootstrap 95% confidence intervals; sensitivity analyses excluded participants with an estimated glomerular filtration rate below 60.
resultsP3NP showed weak bivariate correlations with age (p = -0.210) and the Short Physical Performance Battery (p = 0.225). When incorporated into the clinical model, P3NP did not yield a clinically significant improvement (ΔAUC = 0.007). As a sole predictor, P3NP had poor discrimination (AUC 0.53) and was not independently associated with DXA-defined sarcopenia (odds ratio per 1-standard deviation, p > 0.05). Results were consistent after excluding participants with reduced kidney function and across interaction analyses; model calibration was adequate. P3NP absolute values were elevated, with 80.8% above the high threshold (>31 μg/L), and clinical/functional profiles were broadly similar P3NP strata.
conclusionIn women with T2DM, circulating P3NP was not an independent discriminator of DXA-defined sarcopenia and provided no clinically meaningful advantage over standard clinical predictors. Routine screening should continue to rely on assessments of muscle strength, function, and DXA-based body composition, while P3NP may be considered an adjunct marker of extracellular matrix remodeling.
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