Abstract

ObjectiveTo compare serum levels of tumor necrosis factor alpha (TNF-α) between type 2 diabetes mellitus patients with and without peripheral neuropathy (PN). Also, to study the relation between peripheral nerves conduction velocity and serum level of TNF-α in those patients.Patients and methodsThis study included three groups with 40 patients in each group. Diabetic PN patients (groups I and II) were compared with diabetic patients without PN (group III). Groups I and II differed in the duration of clinical neuropathy with less than 5 years in group I and more than 5 years in group II.All patients were subjected to general and neurological examination, neuropathy symptom score (NSS), neuropathy disability score (NDS), glycosylated hemoglobin (HbA1c), serum level of TNF-α and both sensory and motor nerve conduction study.ResultsThis study showed raised serum levels of TNF-α in diabetic patients with PN, more with increased duration of neuropathy. TNF-α levels showed statistically significant negative correlation with nerve conduction velocity but positive correlations with each of neuropathy disability score, neuropathy symptom score, and glycosylated hemoglobin.ConclusionTNF-α might be involved in the pathogenesis of diabetic PN, and its serum level might be used as a biomarker for the severity of diabetic PN.

Highlights

  • One of the common complications of diabetes is peripheral neuropathy (PN) affecting about 50% of diabetic patients [1, 2]

  • tumor necrosis factor-α (TNF-α) might be involved in the pathogenesis of diabetic PN, and its serum level might be used as a biomarker for the severity of diabetic PN

  • Serum level of TNF-α was found to be increased in diabetic PN patients, and its level was positively correlated with neuropathy symptoms and disability and negatively correlated with nerve conduction velocity

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Summary

Introduction

One of the common complications of diabetes is peripheral neuropathy (PN) affecting about 50% of diabetic patients [1, 2]. It causes progressive degeneration of nerves, making it a big concern for clinicians [3]. Studies show that serum levels of tumor necrosis factor-α (TNF-α) and soluble TNF-α receptors (sTNFR1 and sTNFR2) increased in patients with diabetic PN. Tumor necrosis factor-α is a pro-inflammatory cytokine, produced by activated macrophages and monocytes, that participates in the pathogenesis of diabetic PN [5,6,7,8].

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