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Huang W, Gu L, Wang J, Wang Y, Cao F, Jin T, Cheng Y. Causal association between vitamin D and diabetic neuropathy: a Mendelian randomization analysis. Endocrine 2023; 80:328-335. [PMID: 36754931 DOI: 10.1007/s12020-023-03315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 01/13/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVES Vitamin D has been linked to diabetic neuropathy (DN) in previous epidemiological observational studies, however, their findings are inconsistent. The causal relationship between vitamin D and DN remains unknown. In this study we aim to investigate the causal association of serum 25-hydroxyvitamin D (25OHD) and DN. METHODS Based on summary statistics from publicly available genome-wide association studies (GWAS) database, we detected the genetic correlation between serum 25OHD levels and DN by a two-sample Mendelian randomization (MR) analysis. The inverse-variance weighted (IVW) method was used as the primary analysis, weighted median and MR-Egger were applied as complementary methods for MR estimates. In addition, we took sensitivity analyses including Cochran's Q test, MR-Pleiotropy Residual Sum and Outlier (MR-PRESSO) and leave-one-out analysis to ensure that we obtained stable and reliable results. RESULTS Our MR study showed no significant genetic association between serum 25OHD levels and DN (OR = 1.13, 95% CI = 0.81-1.57, P = 0.46). Furthermore, in the reverse direction analysis, we did not find a significant causal effect of DN and serum 25OHD levels (OR = 0.99, 95% CI = 0.98-1.00, P = 0.09). Results of MR-Egger, Weighted Median were consistent with those of the IVW method. The sensitivity analysis suggesting that no significant heterogeneity and genetic pleiotropy was observed. CONCLUSIONS Our results provided no evidence to support the causal association of serum 25OHD levels with DN.
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Affiliation(s)
- Wei Huang
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 310014, Hangzhou, China
- Rheumatism and Immunity Research Institute, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 310014, Hangzhou, China
| | - Lei Gu
- Department of Rehabilitation, Ningbo Medical Treatment Center Lihuili Hospital, 315000, Ningbo, China
| | - Jingwen Wang
- Department of Neurology, Tiantai People's Hospital Of Zhejiang Province, 317200, Tiantai, China
| | - Yiqi Wang
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 310014, Hangzhou, China
| | - Fangzheng Cao
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 310014, Hangzhou, China
- Department of Neurology, The Second Clinical Medical College, Zhejiang Chinese Medical University, 310014, Hangzhou, China
| | - Tianyu Jin
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 310014, Hangzhou, China.
- Department of Neurology, The Second Clinical Medical College, Zhejiang Chinese Medical University, 310014, Hangzhou, China.
| | - Yifan Cheng
- Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 310014, Hangzhou, China.
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Fundaun J, Kolski M, Molina-Álvarez M, Baskozos G, Schmid AB. Types and Concentrations of Blood-Based Biomarkers in Adults With Peripheral Neuropathies: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2248593. [PMID: 36574244 PMCID: PMC9857490 DOI: 10.1001/jamanetworkopen.2022.48593] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/09/2022] [Indexed: 12/28/2022] Open
Abstract
Importance Peripheral neuropathies are common conditions and can result in numbness, paresthesia, motor deficits, and pain. There is increasing evidence for the use of biomarkers as clinical indicators of the presence, severity, and prognosis of nerve lesions; however, biomarker identification has largely been focused on disorders of the central nervous system, and less is known about their role in the peripheral nervous system. Objective To assess blood-based biomarker concentrations associated with nerve involvement in patients with peripheral neuropathy compared with control participants. Data Sources Ovid, MEDLINE, Embase, and CINAHL were searched from inception to September 23, 2021. Study Selection Observational studies reporting on blood biomarkers in patients diagnosed with peripheral neuropathy were included. This review was preregistered on PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data were abstracted by 1 investigator and independently reviewed by a second. Data Extraction and Synthesis Data were meta-analyzed when at least 2 studies reported the same biomarker with comparable methodology. Fixed-effects models were used when only 2 studies were included; random-effects models were used when more than 2 studies were included. Main Outcomes and Measures The outcome of interest was concentration of biomarkers. Results This review included 36 studies reporting on 4414 participants, including 2113 control participants and 2301 patients with peripheral neuropathy with 13 distinct peripheral neuropathy diagnoses. Diabetic neuropathy was the most common neuropathy diagnosis (13 studies), followed by Charcot-Marie-Tooth disease (6 studies) and Guillain-Barre syndrome (6 studies). Overall, 16 different blood-based biomarkers associated with nerve involvement were evaluated. The most used were neurofilament light chain, S100B, brain-derived neurotrophic factor, and neuron-specific enolase. Patients with peripheral neuropathy demonstrated significantly higher levels of neurofilament light chain compared with controls (standardized mean difference [SMD], 0.93 [95% CI, 0.82 to 1.05]; P < .001). There were no significant differences in levels of S100B (SMD, 1.10 [95% CI, -3.08 to 5.28]; P = .38), brain-derived neurotrophic factor (SMD, -0.52 [95% CI, -2.23 to 1.19]; P = .40), or neuron-specific enolase (SMD, -0.00 [95% CI, -1.99 to 1.98]; P = .10) in patients with peripheral neuropathy compared with control participants. Conclusions and Relevance The findings of this systematic review and meta-analysis support the use of neurofilament light chain as a blood-based measure associated with the presence of neuronal injury in patients with peripheral neuropathy.
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Affiliation(s)
- Joel Fundaun
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Melissa Kolski
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
- Musculoskeletal Outpatient Department, Shirley Ryan AbilityLab, Chicago, Illinois
| | - Miguel Molina-Álvarez
- Area of Pharmacology, Nutrition, and Bromatology, Department of Basic Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain
| | - Georgios Baskozos
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Annina B. Schmid
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
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Rossi R, Talarico M, Pascale A, Pascale V, Minici R, Boriani G. Low Levels of Vitamin D and Silent Myocardial Ischemia in Type 2 Diabetes: Clinical Correlations and Prognostic Significance. Diagnostics (Basel) 2022; 12:2572. [PMID: 36359415 PMCID: PMC9689411 DOI: 10.3390/diagnostics12112572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 07/30/2023] Open
Abstract
Vitamin D deficiency has a pathogenetic and prognostic role in coronary artery disease and a key role in pain transmission. Diabetic patients have a higher risk of silent myocardial ischemia (SMI) due to diabetic neuropathy. We evaluated the correlation between SMI and Vitamin D serum levels in type 2 diabetic patients and assessed whether SMI patients had a worse survival rate than their symptomatic counterpart. We enrolled 253 patients admitted in our Cardiology Unit and compared them with 50 healthy volunteers. We created three sub-groups: symptomatic MI group (125, 32.4%); SMI group (78, 25.7%), and no-MI group (50, 41.9%). 25(OH)D levels (nmol/L) were lower in the SMI group (34.9 ± 5.8) compared to those in the symptomatic MI (49.6 ± 6.1; p = 0.01), no MI (53.1 ± 6.2; p = 0.001), and control groups (62.1 ± 6.7; p = 0.0001). 25(OH)D levels predicted SMI in diabetic patients, with an inverted odds ratio of 1.11 (p = 0.01). Symptomatic MI group survival was higher than the SMI one (6-year survival rate: 83 vs. 69%; p = 0.01). Diabetic patients with SMI had a higher mortality risk and showed lower 25(OH)D levels than the symptomatic group. This suggests the crucial role that vitamin D has in the pathogenesis of SMI.
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Affiliation(s)
- Rosario Rossi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, Policlinico di Modena Hospital, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, MO, Italy
| | - Marisa Talarico
- Cardiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Alessandra Pascale
- Cardiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Vittorio Pascale
- Cardiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Roberto Minici
- Radiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, Policlinico di Modena Hospital, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, MO, Italy
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Zhang L, Du Q, Yao M, Wang M, Ge B. Balance Analysis of Peripheral Neuropathy in Type 2 Diabetes Mellitus Based on Logistic Regression Equation. SCANNING 2022; 2022:2113758. [PMID: 35655714 PMCID: PMC9132714 DOI: 10.1155/2022/2113758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
This paper analyzes the factors of peripheral neuropathy in type 2 diabetes mellitus and puts forward a balanced analysis of peripheral neuropathy in type 2 diabetes mellitus based on logistic regression equation. A total of 1192 eligible patients were selected as the study subjects. All selected patients underwent 75 g oral glucose tolerance test to measure fasting blood glucose and insulin and 2-hour postprandial blood glucose and 2-hour postprandial insulin, as well as neuroelectrophysiological examination. The results showed that the OR values of age, course of disease, fingertip blood glucose immediately after admission, and 2-hour blood glucose were greater than 1, and the P values were all less than 0.05, which were the risk factors of diabetic peripheral neuropathy. OR value of β cell function index (HBCI) is less than 1. P is less than 0.05, and it is a protective factor of diabetic peripheral neuropathy. Laboratory indicators are as follows: 75 g OGTT: 0-hour blood glucose, 2-hour blood glucose, and glycosylated hemoglobin; serum creatinine; glutamate transaminase; fibrinogen; ten items of hemoglobin; and indexes reflecting islet function: islet β is thin, and there are significant differences in cell function index, insulin resistance index, and insulin secretion index between the non-DPN group and DPN group. Age, course of disease, fingertip blood glucose immediately after admission, and blood glucose within 2 hours after admission were the risk factors for diabetic peripheral neuropathy. Islet β cell function index (HBCI) is a protective factor of diabetic peripheral neuropathy.
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Affiliation(s)
- Lixin Zhang
- Nursing Department, The Second Hospital of Shijiazhuang, Hebei 050000, China
| | - Qianqian Du
- Department of Endocrinology, The Second Hospital of Shijiazhuang, Hebei 050000, China
| | - Manman Yao
- Department of Obstetrics and Gynecology, The Second Hospital of Shijiazhuang, Hebei 050000, China
| | - Mai Wang
- Department of Endocrinology, The Second Hospital of Shijiazhuang, Hebei 050000, China
| | - Bing Ge
- Pediatrics Department, The Second Hospital of Shijiazhuang, Hebei 050000, China
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Effect of obesity on the associations of 25-hydroxyvitamin D with prevalent and incident distal sensorimotor polyneuropathy: population-based KORA F4/FF4 study. Int J Obes (Lond) 2022; 46:1366-1374. [PMID: 35474356 PMCID: PMC9239908 DOI: 10.1038/s41366-022-01122-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 11/09/2022]
Abstract
Background/objectives The association between vitamin D and DSPN has been investigated in cross-sectional studies in individuals with diabetes. However, evidence from prospective and population-based studies is still lacking. Also, the potential modifying effect of obesity and glucose tolerance has not been investigated. Therefore, we examined the cross-sectional and prospective associations of serum 25(OH)D with DSPN and assessed possible effect modifications. Subjects/methods The study included individuals aged 62–81 years who participated in the German KORA F4 (2006–2008) and FF4 (2013–2014) studies. DSPN was assessed using the Michigan Neuropathy Screening Instrument. Cross-sectional analyses (n = 1065; 33% of the participants had obesity) assessed the associations of baseline 25(OH)D with prevalent DSPN, while prospective analyses (n = 422) assessed the associations of 25(OH)D with incident DSPN. Results No association was found between 25(OH)D and prevalent DSPN in the total sample after adjustment for age, sex, season of blood sampling, BMI, metabolic variables, lifestyle factors, and comorbidities. However, a decrease by 10 nmol/L in 25(OH)D was associated with prevalent DSPN (RR (95% CI) 1.08 (1.01, 1.16)) in individuals with obesity but not in normal-weight individuals (RR (95% CI) 0.97 (0.92, 1.02), pinteraction = 0.002). No evidence for effect modification by glucose tolerance was found (p > 0.05). In the prospective analysis, 25(OH)D levels in the first and second tertiles were associated with higher risk of DSPN (RR (95% CI) 1.18 (1.02; 1.38) and 1.40 (1.04; 1.90)) compared to the third tertile after adjustment for age, sex, season of blood sampling, and BMI. There was no evidence for effect modification by obesity or glucose tolerance categories. Conclusions Our study did not show consistent evidence for cross-sectional and prospective associations between serum 25(OH)D levels and DSPN in the total study population of older individuals. However, there was evidence for an association between lower serum 25(OH)D levels and higher prevalence of DSPN in individuals with obesity.
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Putz Z, Tordai D, Hajdú N, Vági OE, Kempler M, Békeffy M, Körei AE, Istenes I, Horváth V, Stoian AP, Rizzo M, Papanas N, Kempler P. Vitamin D in the Prevention and Treatment of Diabetic Neuropathy. Clin Ther 2022; 44:813-823. [DOI: 10.1016/j.clinthera.2022.03.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 12/17/2022]
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Ou Y, Liang Z, Yang Y, Zhou YK. Association of Diabetic Peripheral Neuropathy with Vitamin D Levels Depends on Vitamin D Status. Med Sci Monit 2021; 27:e931244. [PMID: 34711797 PMCID: PMC8562010 DOI: 10.12659/msm.931244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Vitamin D deficiency has been reported to be associated with diabetic peripheral neuropathy (DPN). Our objective here was to evaluate the association between vitamin D levels and neuropathic symptoms in a Chinese population. Material/Methods A total of 4435 patients with type 2 diabetes (T2D) were recruited in this cross-sectional study. 25-dihydroxyvitamin D (25-(OH) D) serum concentration was measured by electrochemiluminescence assay (Cobas e601, Roche). DPN was clinically diagnosed by assessing neurological symptoms and performing current perception threshold (CPT) testing. Of all the patients, 2910 were CPT-positive and had assessed neurological symptoms. Results In the vitamin D insufficiency group (<30 ng/mL 25-(OH) D), patients with neurological symptoms had higher serum 25-(OH) D levels than those without neurological symptoms (24.65±3.42 ng/mL vs 23.61±4.54 ng/mL, p≤0.001). The risk of numbness and pain increased by 0.5-fold for every 6 ng/mL increase in 25-(OH) D. In the vitamin D sufficiency group (≥30 ng/mL 25-(OH) D), patients with neurological symptoms had lower serum 25-(OH) D levels than those without neurological symptoms (32.96±3.18 ng/mL vs 33.45±4.27 ng/mL, p<0.01). For every 4 ng/mL decrease in 25-(OH) D, the risk of numbness and pain increased by 0.2-fold. Conclusions The association of neuropathy symptoms with 25-(OH) D levels differed depending on whether the patients had insufficient or sufficient vitamin D.
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Affiliation(s)
- Yang Ou
- Department of Endocrinology and Metabolism, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China (mainland)
| | - Zhi Liang
- Information Center, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China (mainland)
| | - Yang Yang
- Department of Urology, Kunming Yan'an Hospital, Kunming, Yunnan, China (mainland)
| | - Yi-Kun Zhou
- Department of Endocrinology and Metabolism, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, China (mainland)
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GÜNTEL M, UYSAL A. Diyabetik Periferik Nöropati ve Vitamin D İlişkisi. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2021. [DOI: 10.17944/mkutfd.944560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Several studies have been conducted to investigate the relation between 25-hydroxyvitamin D [25(OH)D] level and diabetic neuropathy (DN). However, there is still no clear conclusion due to differences in study design and cut-off values used in the published work, in addition to the absence of a comprehensive meta-analysis (MA) on the topic. The present systematic review and MA therefore aims at clarifying the association between vitamin D level and peripheral DN in patients with type 2 diabetes mellitus. Primary research studies that explored the association between 25(OH)D level and diabetic peripheral neuropathy in type 2 diabetes were located from Medline, EMBASE, Web of Science, Cochrane Library, CINHAL and Google Scholar. Twenty-six studies met the inclusion criteria with 6277 participants where 2218 were diabetic with DN, 2959 were diabetic without DN and 406 were healthy. Diabetic patients with DN showed significantly lower serum 25(OH)D compared with patients without DN (standardised mean difference (SMD) of -0·92 (95 % CI -1·18, -0·65, I2 = 93·3 %, P < 0·0001). The pooled OR value of vitamin D deficiency was higher in patients with DN, 1·84 (95 % CI 1·46, 2·33, P < 0·0001) and 2·87 (95 % CI 1·10, 7·52, P = 0·03) when using fixed-effects and random-effects models, respectively. Vitamin D deficiency has been found to be highly prevalent among diabetic patients with neuropathy. Since 25(OH)D has been implicated in glucose haemostasis and showed benefit in reducing neuropathy symptoms, its supplementation is warranted for this population of patients.
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Gao Y, Chen S, Peng M, Wang Z, Ren L, Mu S, Zheng M. Correlation Between Thioredoxin-Interacting Protein and Nerve Conduction Velocity in Patients With Type 2 Diabetes Mellitus. Front Neurol 2020; 11:733. [PMID: 32774321 PMCID: PMC7387714 DOI: 10.3389/fneur.2020.00733] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/15/2020] [Indexed: 12/24/2022] Open
Abstract
Aims: To investigate the correlation between thioredoxin-interacting protein (TXNIP) and peripheral nerve conduction velocity (NCV) in patients with type 2 diabetes mellitus. Methods: In total, 338 patients with type 2 diabetes mellitus (T2DM) were included in this study. We collected the clinical data and measured the motor conduction velocities of the bilateral ulnar nerve, median nerve, tibial nerve, and common peroneal nerve, and the sensory conduction velocities of the ulnar nerve, median nerve, sural nerve, and superficial peroneal nerve. According to the results, the patients were divided into two groups: normal peripheral nerve conduction group (NCVN group) and abnormal peripheral nerve conduction group (NCVA group). The two groups were then compared in terms of the conventional biochemical index and the sugar metabolic index as well as the serum levels of TXNIP, reduced glutathione (GSH), total superoxide dismutase (SOD), malondialdehyde (MDA), and tumor necrosis factor alpha (TNF-α). The correlation between TXNIP and NCV was also analyzed. Results: Compared with the NCVN group, the TXNIP and MDA values were significantly increased in the NCVA group (P < 0.05). Among the patients with T2DM, age, fasting glucose, SDBG, and TXNIP were risk factors for NCV abnormality, while vitamin D3 was a protective factor. After adjusting for related confounding factors, TXNIP was significantly correlated with NCV (P < 0.05). Among the patients with T2DM, TXNIP was an independent risk factor for left ulnar motor conduction velocity (MCV), right ulnar MCV, left median MCV, and right median MCV. TNF-α was identified as a positive influencing factor for serum TXNIP, while serum TXNIP was a positive factor for TNF-α and MDA (both P < 0.05). Conclusion: Serum TXNIP is related to NCV in T2DM patients. In combination with oxidative stress and inflammation, TXNIP may affect diabetic peripheral neuropathy (DPN).
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Affiliation(s)
- Yuan Gao
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Graduate School of North China University of Science and Technology, Tangshan, China
| | - Shuchun Chen
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Minmin Peng
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Graduate School of Hebei North University, Zhangjiakou, China
| | - Zi Wang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Graduate School of Hebei North University, Zhangjiakou, China
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China
| | - Shumin Mu
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Graduate School of North China University of Science and Technology, Tangshan, China
| | - Meiling Zheng
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, China.,Graduate School of Hebei Medical University, Shijiazhuang, China
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The Role of Oxidative Stress in Peripheral Neuropathy. J Mol Neurosci 2020; 70:1009-1017. [PMID: 32103400 DOI: 10.1007/s12031-020-01495-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/05/2020] [Indexed: 12/17/2022]
Abstract
Peripheral neuropathy (PN) is a common disease affecting about 5% of the general population after the age of 50. Causes of PN are numerous and include genetic, diabetes, alcohol, vitamin deficiencies, and gluten sensitivity among others. This systematic review aimed to study the association between oxidative stress and PN in an attempt to better understand PN pathogenesis. A computer-based, systematic search was conducted on the PubMed database, and ensuing data from included articles was analyzed and discussed in this review. Sixty-nine papers were eligible and were used for this review. Peripheral neuropathy is associated with an increase of reactive oxygen species and a decrease in endogenous antioxidants. Genetic predisposition to oxidative damage may be a factor. Antioxidant treatment is promising regarding treatment. Though further research is necessary to better understand the underlying mechanism, it is evident that oxidative stress is implicated in the pathogenesis of - or is at least systematically present in - PN.
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Ahmed AEA, Sakhr HM, Hassan MH, El-Amir MI, Ameen HH. Vitamin D receptor rs7975232, rs731236 and rs1544410 single nucleotide polymorphisms, and 25-hydroxyvitamin D levels in Egyptian children with type 1 diabetes mellitus: effect of vitamin D co-therapy. Diabetes Metab Syndr Obes 2019; 12:703-716. [PMID: 31190930 PMCID: PMC6526182 DOI: 10.2147/dmso.s201525] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/04/2019] [Indexed: 12/13/2022] Open
Abstract
Purpose: We aimed to examine the possible association role of vitamin D and vitamin D receptor (VDR) single nucleotide polymorphisms (SNPs) in type 1 diabetes mellitus (T1DM) development, glycemic control and complications among a cohort of Egyptian children. Subjects and methods: A prospective case-control study has been conducted on 50 Egyptian children with T1DM who were comparable with 50 controls. Vitamin D and HbA1c were measured. VDR-SNPs [ApaI (rs7975232), TaqI (rs731236) and BsmI (rs1544410)] detection was done by polymerase chain reaction through restriction fragment length polymorphism (PCR-RFLP) technique. Vitamin D supplements were given to the included T1DM children with low vitamin D and reassessments of both HbA1c% and 25(OH)D serum levels were performed in those children three months later. Results: Eighty percent of the included diabetic patients have poor glycemic control. Vitamin D was deficient in 68% and insufficient in 16% of diabetic patients. Significant improvements in both vitamin D and glycemic status among T1DM children, who have low vitamin D and received vitamin D supplementations. There were significantly negative correlations between serum levels of vitamin D with both HbA1c % (r= -0.358, P˂0.05) and daily insulin dose (r=-0.473, P˂0.05). Compared with controls, T1DM children presented more commonly with ApaI a allele (OR: 2.87; 95%CI: 1.39-5.91, P˂0.05) and BsmI b allele (OR: 4.38; 95%CI: 2.30-8.33, P˂0.05). TaqI t allele wasn't significantly differing among patients and controls (P˃0.05). Aa+aa and Bb+bb genotypes were significantly higher among T1DM vs the controls (OR: 3.08;, 95%CI: 1.33-7.15, P˂0.05 and OR: 9.33; 95%CI: 3.61-24.17, P˂0.05respectively). Conclusion: ApaI and BsmI were associated with risk of T1DM development among Egyptian children. Low vitamin D status was frequently occurring among T1DM with significant improvement in the glycemic control of such children when adding vitamin D supplements to the standard insulin therapy.
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Affiliation(s)
- Ahmed El-Abd Ahmed
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Hala M Sakhr
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Mostafa I El-Amir
- Department of Medical Microbiology and Immunology, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Hesham H Ameen
- Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, Egypt
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Faye PA, Poumeaud F, Miressi F, Lia AS, Demiot C, Magy L, Favreau F, Sturtz FG. Focus on 1,25-Dihydroxyvitamin D3 in the Peripheral Nervous System. Front Neurosci 2019; 13:348. [PMID: 31031586 PMCID: PMC6474301 DOI: 10.3389/fnins.2019.00348] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 03/26/2019] [Indexed: 12/13/2022] Open
Abstract
In this review, we draw attention to the roles of calcitriol (1,25-dihydroxyvitamin D3) in the trophicity of the peripheral nervous system. Calcitriol has long been known to be crucial in phosphocalcium homeostasis. However, recent discoveries concerning its involvement in the immune system, anti-cancer defenses, and central nervous system development suggest a more pleiotropic role than previously thought. Several studies have highlighted the impact of calcitriol deficiency as a promoting factor of various central neurological diseases, such as multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, and Alzheimer's disease. Based on these findings and recent publications, a greater role for calcitriol may be envisioned in the peripheral nervous system. Indeed, calcitriol is involved in myelination, axonal homogeneity of peripheral nerves, and neuronal-cell differentiation. This may have useful clinical consequences, as calcitriol supplementation may be a simple means to avoid the onset and/or development of peripheral nervous-system disorders.
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Affiliation(s)
- Pierre Antoine Faye
- EA 6309, Myelin Maintenance and Peripheral Neuropathies, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.,Department of Biochemistry and Molecular Genetics, University Hospital of Limoges, Limoges, France
| | - François Poumeaud
- EA 6309, Myelin Maintenance and Peripheral Neuropathies, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Federica Miressi
- EA 6309, Myelin Maintenance and Peripheral Neuropathies, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Anne Sophie Lia
- EA 6309, Myelin Maintenance and Peripheral Neuropathies, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.,Department of Biochemistry and Molecular Genetics, University Hospital of Limoges, Limoges, France
| | - Claire Demiot
- EA 6309, Myelin Maintenance and Peripheral Neuropathies, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France
| | - Laurent Magy
- CHU de Limoges, Reference Center for Rare Peripheral Neuropathies, Department of Neurology, Limoges, France
| | - Frédéric Favreau
- EA 6309, Myelin Maintenance and Peripheral Neuropathies, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.,Department of Biochemistry and Molecular Genetics, University Hospital of Limoges, Limoges, France
| | - Franck G Sturtz
- EA 6309, Myelin Maintenance and Peripheral Neuropathies, Faculties of Medicine and Pharmacy, University of Limoges, Limoges, France.,Department of Biochemistry and Molecular Genetics, University Hospital of Limoges, Limoges, France
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Grammatiki M, Karras S, Kotsa K. The role of vitamin D in the pathogenesis and treatment of diabetes mellitus: a narrative review. Hormones (Athens) 2019; 18:37-48. [PMID: 30255482 DOI: 10.1007/s42000-018-0063-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/09/2018] [Indexed: 12/21/2022]
Abstract
Diabetes mellitus, a metabolic disorder associated with chronic complications, is traditionally classified into two main subtypes. Type 1 diabetes mellitus (T1DM) results from gradual pancreatic islet β cell autoimmune destruction, extending over months or years. Type 2 diabetes mellitus (T2DM) is a heterogeneous disorder, with both insulin resistance and impairment in insulin secretion contributing to its pathogenesis. Vitamin D is a fat-soluble vitamin with an established role in calcium metabolism. Recently, several studies have provided evidence suggesting a role for it in various non-skeletal metabolic conditions, including both types of diabetes mellitus. Preclinical studies of vitamin D action on insulin secretion, insulin action, inflammatory processes, and immune regulation, along with evidence of an increase of hypovitaminosis D worldwide, have prompted several epidemiological, observational, and supplementation clinical studies investigating a potential biological interaction between hypovitaminosis D and diabetes. This narrative review aims to summarize current knowledge on the effect of vitamin D on T1DM and T2DM pathogenesis, prevention, and treatment, as well as on micro- and macrovascular complications of the disease. Furthermore, on the basis of current existing evidence, we aim to highlight areas for potential future research.
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Affiliation(s)
- Maria Grammatiki
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Spiros Karras
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Kalliopi Kotsa
- Department of Endocrinology and Metabolism-Diabetes Center, 1st Department of Internal Medicine, AHEPA University Hospital, S. Kiriakidi 1, 54636, Thessaloniki, Greece.
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15
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Shillo P, Selvarajah D, Greig M, Gandhi R, Rao G, Wilkinson ID, Anand P, Tesfaye S. Reduced vitamin D levels in painful diabetic peripheral neuropathy. Diabet Med 2019; 36:44-51. [PMID: 30102801 DOI: 10.1111/dme.13798] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2018] [Indexed: 12/25/2022]
Abstract
AIM Recent studies have reported an association between low vitamin D levels and diabetic peripheral neuropathy. However, many of these did not differentiate between people with painful diabetic peripheral neuropathy and those with painless diabetic peripheral neuropathy, or assess major confounding factors including sunlight exposure and daily activity. Our study addressed these limitations and evaluated vitamin D levels in people with carefully phenotyped diabetic peripheral neuropathy and controls. METHODS Forty-five white Europeans with Type 2 diabetes and 14 healthy volunteers underwent clinical and neurophysiological assessments. People with Type 2 diabetes were then divided into three groups (17 with painful diabetic peripheral neuropathy, 14 with painless diabetic peripheral neuropathy and 14 with no diabetic peripheral neuropathy). All had seasonal sunlight exposure and daily activity measured, underwent a lower limb skin biopsy and had 25-hydroxyvitamin D measured during the summer months, July to September. RESULTS After adjusting for age, BMI, activity score and sunlight exposure, 25-hydroxyvitamin D levels (nmol/l) (se) were significantly lower in people with painful diabetic peripheral neuropathy [painful diabetic peripheral neuropathy 34.9 (5.8), healthy volunteers 62.05 (6.7), no diabetic peripheral neuropathy 49.6 (6.1), painless diabetic peripheral neuropathy 53.1 (6.2); ANCOVAP = 0.03]. Direct logistic regression was used to assess the impact of seven independent variables on painful diabetic peripheral neuropathy. Vitamin D was the only independent variable to make a statistically significant contribution to the model with an inverted odds ratio of 1.11. Lower 25-hydroxyvitamin D levels also correlated with lower cold detection thresholds (r = 0.39, P = 0.02) and subepidermal nerve fibre densities (r = 0.42, P = 0.01). CONCLUSIONS We have demonstrated a significant difference in 25-hydroxyvitamin D levels in well-characterized people with painful diabetic peripheral neuropathy, while accounting for the main confounding factors. This suggests a possible role for vitamin D in the pathogenesis of painful diabetic peripheral neuropathy. Further prospective and intervention trials are required to prove causality between low vitamin D levels and painful diabetic peripheral neuropathy.
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Affiliation(s)
- P Shillo
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - D Selvarajah
- Department of Oncology and Human Metabolism, University of Sheffield, Sheffield
| | - M Greig
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - R Gandhi
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - G Rao
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
| | - I D Wilkinson
- Academic Unit of Radiology, University of Sheffield, Sheffield
| | - P Anand
- Peripheral Neuropathy Unit, Imperial College London, London, UK
| | - S Tesfaye
- Diabetes Research Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield
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16
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Alkhatatbeh M, Abdul-Razzak KK. Neuropathic pain is not associated with serum vitamin D but is associated with female gender in patients with type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2019; 7:e000690. [PMID: 31275577 PMCID: PMC6577304 DOI: 10.1136/bmjdrc-2019-000690] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/10/2019] [Accepted: 05/28/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Neuropathic pain is a common complication of diabetes mellitus (DM). Patients may complain of several neuropathic symptoms including impaired peripheral sensation, numbness, tingling, burning, and pain. Because these symptoms may cross with symptoms of vitamin D deficiency, we hypothesized that neuropathic pain and vitamin D deficiency may be associated in patients with type 2 DM. RESEARCH DESIGN AND METHODS This is a cross-sectional study that involved 239 participants with type 2 DM. Neuropathic pain was assessed using PainDETECT questionnaire. Serum 25-hydroxyvitamin D was measured by the electrochemiluminescence immunoassay, fasting blood glucose was measured by the hexokinase method and hemoglobin A1c was measured by the turbidimetric inhibition immunoassay. RESULTS The prevalence of neuropathic pain among type 2 DM participants was 26.8%. Vitamin D deficiency was reported in 67.8% of type 2 DM participants. The neuropathy score for females was significantly higher than that for males (p<0.01). There was no significant difference in serum vitamin D between type 2 DM participants according to their gender and according to their neuropathy status (p>0.05). Ordinal logistic regression analysis has shown that female gender was the only significant predictor of neuropathic pain among type 2 DM participants (p<0.01 with an OR (95% CI) of 2.45 (1.29 to 4.67)). CONCLUSIONS Neuropathic pain was not associated with serum vitamin D but was associated with female gender in type 2 DM. Because our results were not consistent with other studies that used different neuropathy assessment tools, we suggest that further research should be conducted to check the validity of these tools in identifying subjects with neuropathy.
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Affiliation(s)
- Mohammad Alkhatatbeh
- Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid K Abdul-Razzak
- Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Takahashi H, Watanabe Y, Tanaka H, Mihara M, Mochizuki H, Liu T, Wang Y, Tomiyama N. Quantifying changes in nigrosomes using quantitative susceptibility mapping and neuromelanin imaging for the diagnosis of early-stage Parkinson's disease. Br J Radiol 2018; 91:20180037. [PMID: 29498540 DOI: 10.1259/bjr.20180037] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To quantify nigral changes with a focus on their spatial variation within the substantia nigra pars compacta (SNpc) for diagnosing early-stage Parkinson's disease (PD). METHODS The study participants were 18 patients with early-stage PD (PD group) and 18 healthy controls (HC group) who underwent quantitative susceptibility mapping (QSM) and neuromelanin imaging. The QSM and neuromelanin values in each whole SNpc containing the entire nigrosome and dorsolateral SNpc containing nigrosome 1 were calculated. The neuromelanin area was defined as the volume with a signal-to-noise ratio higher than that of the background region. The significance of intergroup differences in the QSM value and neuromelanin area in each SNpc region was tested. Logit (p) was used to estimate the probability of PD in relation to the QSM value and the neuromelanin area, and receiver operating characteristic analyses were performed for each value. RESULTS In both SNpc, QSM values were significantly higher and neuromelanin areas were significantly lower in the PD group compared with the HC group (p < 0.05). The respective areas under the receiver operating characteristic curve for the two groups were 0.70/0.73 for the QSM value, 0.81/0.78 for the neuromelanin area in the whole/dorsolateral SNpc, and 0.86 for logit (p) in relation to the QSM value of the dorsolateral SNpc and the neuromelanin area of the whole SNpc. CONCLUSION Comprehensive MRI assessment of the abnormality involving the nigrosomes can yield a high diagnostic performance for early-stage PD. Advances in knowledge: Focusing on spatial differences in nigral changes within the SNpc can increase the sensitivity of the detection of PD-related neurodegenerative changes.
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Affiliation(s)
- Hiroto Takahashi
- 1 Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine , Osaka , Japan
| | - Yoshiyuki Watanabe
- 1 Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine , Osaka , Japan
| | - Hisashi Tanaka
- 1 Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine , Osaka , Japan
| | - Masahito Mihara
- 2 Department of Neurology, Osaka University Graduate School of Medicine , Osaka , Japan
| | - Hideki Mochizuki
- 2 Department of Neurology, Osaka University Graduate School of Medicine , Osaka , Japan
| | - Tian Liu
- 3 Departments of Biomedical Engineering and Radiology, Cornell University, MedImageMetric LLC , New York, NY , USA
| | - Yi Wang
- 4 Departments of Radiology and Biomedical Engineering, Cornell University , New York, NY , USA
| | - Noriyuki Tomiyama
- 1 Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine , Osaka , Japan
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Tirabassi G, Cutini M, Salvio G, Cerqueni G, Lenzi A, Balercia G. Influence of vitamin D levels on the cardiovascular profile of hypogonadal men. J Endocrinol Invest 2017; 40:1007-1014. [PMID: 28391585 DOI: 10.1007/s40618-017-0671-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/31/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE A large body of evidence suggests a role for vitamin D in conditioning cardiovascular risk. Therefore, it can be hypothesized that vitamin D might also play a role in influencing the metabolic profile of hypogonadal men. In this work, we aimed at evaluating if any relationship exists between vitamin D levels and cardiovascular parameters in male hypogonadism. METHODS Hypogonadal patients attending our andrology unit were retrospectively reviewed. Clinical and biochemical parameters were evaluated. RESULTS 103 patients were studied (51 non-diabetic and 52 diabetic subjects). Mean age of the whole sample was 65 years (standard error of the mean: 0.62). Significant correlations of age, total testosterone, parathyroid hormone (PTH), calcemia, and 25-OH vitamin D with the metabolic profile were found. In logistic regression models including age, total testosterone, PTH, calcemia and 25-OH vitamin D as independent variables, lower levels of 25-OH vitamin D were associated with high values of body mass index (BMI) [odds ratio (OR) 0.910, p 0.019], insulin (OR 0.918, p 0.034), homeostatic model assessment (HOMA) index (OR 0.918, p 0.030), total cholesterol (OR 0.819, p < 0.001), triglycerides (OR 0.820, p < 0.001), and low-density lipoprotein cholesterol (OR 0.923, p 0.034). In non-diabetic subjects, lower levels of 25-OH vitamin D were associated with high values of BMI, insulin, HOMA, triglycerides, systolic, and diastolic blood pressure. On the other hand, in diabetic subjects, lower levels of 25-OH vitamin D were associated with high values of total cholesterol and triglycerides. CONCLUSIONS Our work shows the influence of vitamin D on cardiovascular profile in male hypogonadism. This effect seems to be more relevant in non-diabetic subjects. If these data were to be confirmed, vitamin D assessment might become mandatory in the clinical evaluation of cardiovascular profile in male hypogonadism.
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Affiliation(s)
- G Tirabassi
- Andrology Unit, Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy
| | - M Cutini
- Andrology Unit, Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy
| | - G Salvio
- Andrology Unit, Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy
| | - G Cerqueni
- Istology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - A Lenzi
- Andrology, Pathophysiology of Reproduction and Endocrine Diagnosis Unit, Policlinic Umberto I, University of Rome ''La Sapienza'', Rome, Italy
| | - G Balercia
- Andrology Unit, Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy.
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