RT Journal Article
SR Electronic
T1 Deficits in systemic biomarkers of neuroinflammation and growth factors promoting nerve regeneration in patients with type 2 diabetes and polyneuropathy
JF BMJ Open Diabetes Research & Care
JO BMJ Open Diab Res Care
FD American Diabetes Association
SP e000752
DO 10.1136/bmjdrc-2019-000752
VO 7
IS 1
A1 Dan Ziegler
A1 Alexander Strom
A1 Gidon J Bönhof
A1 Julia M Kannenberg
A1 Margit Heier
A1 Wolfgang Rathmann
A1 Annette Peters
A1 Christina Meisinger
A1 Michael Roden
A1 Barbara Thorand
A1 Christian Herder
YR 2019
UL http://drc.bmj.com/content/7/1/e000752.abstract
AB Introduction The determinants and mechanisms contributing to diabetic sensorimotor polyneuropathy (DSPN) remain unclear. Since neuroinflammation and altered nerve regeneration have been implicated in the pathogenesis of both DSPN and neuropathic pain, we hypothesized that the corresponding biomarkers could be associated with DSPN in general and could have the potential to discriminate between the painful and painless DSPN entities.Methods In a cross-sectional study using multimarker proximity extension assay technology we assessed 71 serum biomarkers including cytokines, chemokines, growth factors, receptors, and others in patients with type 2 diabetes with DSPN (DSPN+) (n=304) or without DSPN (DSPN−) (n=158) and persons with normal glucose tolerance (NGT) without polyneuropathy (n=354).Results After adjustment for multiple testing and sex, age, body mass index, HbA1c, and smoking, the serum levels of 17 biomarkers (four cytokines, five chemokines, four growth factors, two receptors, two miscellaneous) were lower in DSPN+ than in DSPN− and NGT. In DSPN+, six of these biomarkers were associated with peripheral nerve function. The concentrations of 15 other biomarkers differed between NGT and both DSPN+ and DSPN−, but not between DSPN+ and DSPN−. No differences in biomarker levels were found between patients with painful (n=164) and painless DSPN (n=140).Conclusions Deficits in systemic cytokines, chemokines, and growth factors promoting nerve regeneration in patients with type 2 diabetes are linked to polyneuropathy in general but not specifically to the painful or painless entity.Trial registration number NCT02243475.