Elevated serum homocysteine level in the development of diabetic peripheral neuropathy

Zheng, Lidan; Zhang, H L; GUAN, ZHIBO; Hu, Meiqing; Zhang, T; Ge, Shengjie

doi:10.4238/2015.november.30.14

Cited by 11 publications

(8 citation statements)

References 31 publications

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“…Kim et al reported that serum total bilirubin level was conversely linked with DPN [22]. Zheng et al showed that enhanced serum levels of homocysteine increased the risk of DPN development in patients [23]. Therefore, in the current study, we hypothesized that the serum NGF and BDNF levels would be beneficial to understanding the development mechanism and finding new therapeutic targets for DPN detection and treatment.…”

Section: Discussionmentioning

confidence: 89%

Diagnostic Significance of Serum Levels of Nerve Growth Factor and Brain Derived Neurotrophic Factor in Diabetic Peripheral Neuropathy

Sun

Tang²,

Yin³

et al. 2018

Med Sci Monit

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BackgroundOur study aimed to explore the levels of nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF) in healthy participants, type 2 diabetes mellitus (T2DM) patients, and diabetic peripheral neuropathy (DPN) patients in order to find their effects on DPN.Material/MethodsThe clinical data of 110 healthy participants (age: 57.3±8.2 year, height: 165.4±5.5 cm, weight: 64.1±7.5 kg), 83 T2DM patients (age: 56.5±7.9 year, height: 164.8±6.2 cm, and weight: 63.6±6.6 kg), and 65 DPN patients (age: 58.2±7.3 year, height: 166.7±6.7 cm, weight: 63.1±5.8 kg) were observed. ELISA was applied to detect serum NGF and BDNF levels. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic value of serum NGF and BDNF levels in DPN. Logistic regression analysis was performed to analyze risk factors for DPN.ResultsSerum NGF and BDNF levels decreased most in DPN patients. Subsequently, we determined that serum NGF and BDNF levels were correlated with: the course of disease for patients, fasting C-peptide (FCP), 2-hour postprandial C-peptide level (2-h PCP), glycosylated hemoglobin level (HbAlc), and 24-hour urinary microalbumin excretion (24-h UME). ROC curve analysis identified high sensitivity, specificity, and accuracy of NGF and BDNF levels on DPN. Serum levels of NGF and BDNF, course of disease, 2-h PCP level, and postprandial blood glucose level were determined to be risk factors for DPN.ConclusionsOur study highlights that serum levels of NGF and BDNF might be associated with the occurrence and development of DPN.

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Section: Discussionmentioning

confidence: 89%

Diagnostic Significance of Serum Levels of Nerve Growth Factor and Brain Derived Neurotrophic Factor in Diabetic Peripheral Neuropathy

Sun

Tang²,

Yin³

et al. 2018

Med Sci Monit

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“…One study of 409 T2DM patients who underwent stress myocardial perfusion imaging showed that HCY levels were significantly associated with low levels of LVEF in the univariate analyses, and were independent of age, gender, smoking, blood pressure, renal function, folates, vitamin B12, lipid parameters, and hepatic enzymes (21). Other studies have shown increases in plasma HCY concentration in proliferative diabetic retinopathy, diabetic nephropathy, and diabetic peripheral neuropathy patients (22)(23)(24). Ala showed higher HCY levels in T2DM patients, and that HCY levels worsened with increased insulin resistance, dyslipidaemia, and poor glucose control (11).…”

Section: Discussionmentioning

confidence: 99%

Association between plasma homocysteine levels and pancreatic islet beta-cell function in the patients with type 2 diabetes mellitus: a cross-sectional study from China

Yuan¹,

Ding²,

Zhou³

et al. 2021

Ann Palliat Med

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Background: This study sought to investigate the association between plasma homocysteine (HCY) levels and pancreatic islet beta-cell function in type 2 diabetes mellitus (T2DM) patients.Methods: 430 hospitalized T2DM patients were enrolled in this cross-sectional study from December 2013 to December 2016. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. Blood samples were collected from all participants. A 75-g oral glucose tolerance test (OGTT) was performed to diagnose T2DM in each individual, and an insulin releasing test (IRT) was used to calculate selected parameters for glucose, insulin, and C-peptide. Linear correlation and multivariate regression analyses were performed to assess the association between serum HCY concentration and these parameters.Results: Patients were divided into the following subgroups based on quartiles of serum HCY levels:

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“…While distal microcirculation of the hallux has been demonstrated to decrease in healthy subjects and those with Type 2 diabetes and intact skin, blood flow velocity on the dorsal foot significantly increased. This may have occurred due to differences in capillary density or due to a local "steal phenomenon" caused by vasodilation of the more proximal medium sized arterioles [35][36][37]. In subjects with a diabetic foot ulceration, distal hallux microcirculation increased after 14 sessions of one hour daily PEMF therapy performed over three-week timeframe.…”

Section: Discussionmentioning

confidence: 99%

A Randomized, Sham-Controlled, Double-Blind Pilot Study of Pulsed Electromagnetic Field Therapy to Evaluate Small Fiber Nerve Growth and Function and Skin Perfusion in Subjects with Painful Peripheral Diabetic Neuropathy

Aj¹,

Rp²,

Muhlenfeld³

et al. 2017

J Diabetic Complications Med

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Abstract:Purpose: The objective of this study was to determine the potential efficacy and safety of dual energy pulsed electromagnetic field therapy (PEMF) on painful distal symmetric diabetic sensorimotor polyneuropathy (DSPN).Methodology: Subjects with Type 2 diabetes and painful DSPN were randomized to receive either an active or sham PEMF device. Objective measures of efficacy (skin biopsy, nerve conduction velocity (NCV) studies, dorsal and plantar foot skin perfusion pressure (SPP) were performed prior to and following 60-days of twice daily 30 minute treatments. Patient reported outcomes included perception of pain, concomitant medication use and adverse events.Major findings: Dorsal foot SPP improved with PEMF (n=11), change from baseline=19.6 mmHg) vs. sham (n=7, change=-17.4 mmHg), p=0.03. Trends in favor of PEMF vs sham were observed for medial nerve (n=4), planter nerve (n=4) and sural nerve (n=15) onset time and amplitude (p>0.05) other than medial planter onset time (p=0.04). Although change in pain scores were similar, compliance with device use was higher in the active group compared to the sham control. The series of tests and long-term use of PEMF was well-tolerated and feasible. No device related adverse effects were recorded.Principal conclusions: Twice daily PEMF therapy was feasible, well-tolerated, and associated with trends suggesting improved nerve function and microcirculation in patients with painful DSPN. Future, large randomized controlled trials are necessary to confirm these findings and evaluate the potential longer term benefits on symptoms and pathology of DSPN.Keywords: Diabetes; Nerve conduction velocity; Peripheral neuropathy; Pulsed electromagnetic field; Skin biopsy; Skin perfusion pressure Key MessagesPainful diabetic neuropathy affects the majority of patients with diabetes during their lifetime. The presence of diabetic neuropathy increases the potential for diabetes-related lower extremity complications.The aim of this randomized, sham-controlled trial was to determine the feasibility and effects of 60 days of treatment with PEMF therapy on skin perfusion, nerve growth and function as well as pain perception, compliance and safety in subjects with painful diabetic neuropathy. Nineteen patients (12 active; 7 sham) participated in this study.This pilot study demonstrated feasibility of use and trends in favor of PEMF in nerve function and skin perfusion of the dorsal foot. Although a reduction in average pain intensity score was not observed, subjects in the active group were relatively more compliant with device use. No device adverse effects were reported.

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Elevated serum homocysteine level in the development of diabetic peripheral neuropathy

Cited by 11 publications

References 31 publications

Diagnostic Significance of Serum Levels of Nerve Growth Factor and Brain Derived Neurotrophic Factor in Diabetic Peripheral Neuropathy

Diagnostic Significance of Serum Levels of Nerve Growth Factor and Brain Derived Neurotrophic Factor in Diabetic Peripheral Neuropathy

Association between plasma homocysteine levels and pancreatic islet beta-cell function in the patients with type 2 diabetes mellitus: a cross-sectional study from China

A Randomized, Sham-Controlled, Double-Blind Pilot Study of Pulsed Electromagnetic Field Therapy to Evaluate Small Fiber Nerve Growth and Function and Skin Perfusion in Subjects with Painful Peripheral Diabetic Neuropathy

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