Distal lower limb strength is reduced in subjects with impaired glucose tolerance and is related to elevated intramuscular fat level and vitamin D deficiency

Almurdhi, Monirah M; Reeves, Neil D.; Bowling, Frank L.; Boulton, Andrew J.M.; Jeziorska, Maria; Malik, Rayaz A.

doi:10.1111/dme.13163

Cited by 16 publications

(7 citation statements)

References 30 publications

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“…The association of abnormal LDI Flare and QTT testing with mixed fiber neuropathy, as reflected by the clinical and electrophysiological examinations, is in agreement with previous studies[4,5,12–14]. Patients with abnormal small fiber testing in our cohort, had more frequent limb muscle weakness, reduced vibration and proprioception perception, and absent ankle reflexes on the neurological examination, indicating concomitant large fiber impairment.…”

Section: Discussionsupporting

confidence: 92%

Laser Doppler Flare Imaging and Quantitative Thermal Thresholds Testing Performance in Small and Mixed Fiber Neuropathies

et al. 2016

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IntroductionSmall fiber neuropathy might be a part of typical mixed small and large fiber neuropathy, or a distinct entity, affecting exclusively small nerve fibers.ObjectivesExplore the utility of small nerve fiber testing in patients with clinical presentation suggesting small fiber neuropathy, with and without evidence for concomitant large fiber neuropathy.MethodsPatients attending the neuromuscular clinic from 2012 to 2015 with a clinical presentation suggesting small nerve fiber impairment, who had Laser Doppler flare imaging (LDIFlare) and quantitative thermal testing (QTT) were evaluated for this study. Patients with clinical or electrophysiological evidence for concomitant large fiber neuropathy were not excluded.ResultsThe sensitivities of LDIFlare, cooling and heat threshold testing were 64%, 36%, and 0% respectively for clinically highly suggestive small fiber neuropathy, 64%, 56%, and 19% respectively for mixed fiber neuropathy, and 86%, 79%, and 29% respectively for diabetic mixed fiber neuropathy.DiscussionLDIFlare and cooling thresholds testing are non-invasive small nerve fiber testing modalities, with moderate performance in patients with small and mixed fiber neuropathy, and excellent performance in diabetic mixed fiber neuropathy.

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Section: Discussionsupporting

confidence: 92%

Laser Doppler Flare Imaging and Quantitative Thermal Thresholds Testing Performance in Small and Mixed Fiber Neuropathies

et al. 2016

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“…This finding is consistent with our recent finding that people with Type 2 diabetes had a significantly reduced lower limb muscle strength, which was related to the severity of neuropathy but not to the level of vitamin D [7]. Although, in people with IGT we have recently shown a significant reduction in distal muscle strength, which was associated with increased intramuscular non-contractile tissue, small-fibre neuropathy and vitamin D deficiency [12].…”

Section: Discussionsupporting

confidence: 92%

“…Whilst the present results confirm previous findings of a reduction in ankle joint strength and power during walking in people with Type 2 diabetes , we also showed that participants with IGT had a reduction in ankle joint power during walking. These findings are supported by our recent data showing a significant weakness of the distal ankle plantar flexors in people with Type 2 diabetes and people with IGT .…”

Section: Discussionsupporting

confidence: 90%

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Altered walking strategy and increased unsteadiness in participants with impaired glucose tolerance and Type 2 diabetes relates to small‐fibre neuropathy but not vitamin D deficiency

et al. 2017

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“…Vitamin D deficiency and insufficiency, when combined typically defined as 25(OH)D concentrations < 50 nmol/L, are associated with muscle atrophy and deficits in muscle strength in several clinical models (Sato et al, 2005;Tagliafico et al, 2010;van Langenberg et al, 2014;Almurdhi et al, 2017;Bang et al, 2018). While many studies of vitamin D deficiency and insufficiency focus on its impact on protein synthesis and degradation, there is also a growing body of evidence to suggest that vitamin D supplementation in deficient individuals improves measures of mitochondrial density and function (Sinha et al, 2013;Rana et al, 2014).…”

Section: Vitamin D and Mitochondrial Healthmentioning

confidence: 99%

Vitamin D Promotes Skeletal Muscle Regeneration and Mitochondrial Health

et al. 2021

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Vitamin D is an essential nutrient for the maintenance of skeletal muscle and bone health. The vitamin D receptor (VDR) is present in muscle, as is CYP27B1, the enzyme that hydroxylates 25(OH)D to its active form, 1,25(OH)D. Furthermore, mounting evidence suggests that vitamin D may play an important role during muscle damage and regeneration. Muscle damage is characterized by compromised muscle fiber architecture, disruption of contractile protein integrity, and mitochondrial dysfunction. Muscle regeneration is a complex process that involves restoration of mitochondrial function and activation of satellite cells (SC), the resident skeletal muscle stem cells. VDR expression is strongly upregulated following injury, particularly in central nuclei and SCs in animal models of muscle injury. Mechanistic studies provide some insight into the possible role of vitamin D activity in injured muscle. In vitro and in vivo rodent studies show that vitamin D mitigates reactive oxygen species (ROS) production, augments antioxidant capacity, and prevents oxidative stress, a common antagonist in muscle damage. Additionally, VDR knockdown results in decreased mitochondrial oxidative capacity and ATP production, suggesting that vitamin D is crucial for mitochondrial oxidative phosphorylation capacity; an important driver of muscle regeneration. Vitamin D regulation of mitochondrial health may also have implications for SC activity and self-renewal capacity, which could further affect muscle regeneration. However, the optimal timing, form and dose of vitamin D, as well as the mechanism by which vitamin D contributes to maintenance and restoration of muscle strength following injury, have not been determined. More research is needed to determine mechanistic action of 1,25(OH)D on mitochondria and SCs, as well as how this action manifests following muscle injury in vivo. Moreover, standardization in vitamin D sufficiency cut-points, time-course study of the efficacy of vitamin D administration, and comparison of multiple analogs of vitamin D are necessary to elucidate the potential of vitamin D as a significant contributor to muscle regeneration following injury. Here we will review the contribution of vitamin D to skeletal muscle regeneration following injury.

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Distal lower limb strength is reduced in subjects with impaired glucose tolerance and is related to elevated intramuscular fat level and vitamin D deficiency

Cited by 16 publications

References 30 publications

Laser Doppler Flare Imaging and Quantitative Thermal Thresholds Testing Performance in Small and Mixed Fiber Neuropathies

Laser Doppler Flare Imaging and Quantitative Thermal Thresholds Testing Performance in Small and Mixed Fiber Neuropathies

Altered walking strategy and increased unsteadiness in participants with impaired glucose tolerance and Type 2 diabetes relates to small‐fibre neuropathy but not vitamin D deficiency

Vitamin D Promotes Skeletal Muscle Regeneration and Mitochondrial Health

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