Impaired Vascular Endothelial Function is Associated with Peripheral Neuropathy in Patients with Type 2 Diabetes

Abstract

Purpose It is believed that vascular endothelial dysfunction is involved in the occurrence of cardiovascular disease (CVD), and diabetic peripheral neuropathy (DPN) is associated with flow-mediated dilation (FMD), however, the correlation is still unclear. Aims of the present study is to explore the relationship between DPN parameters and FMD, providing a new approach for the prevention of CVD. Patients and Methods A total of 272 patients with T2DM from the Department of Endocrinology of The First Hospital of Lanzhou University according to the grading criteria were selected. FMD was measured by a new vascular ultrasound system and patients were divided into FMD>7%, 4%≤FMD≤7%, and FMD<4% groups. The Toronto Clinical Scoring System (TCSS) was used to assess the severity of DPN. The nerve conduction studies (NCS) assessed large fibre neuropathy by nerve conduction velocity (CV), compound muscle action potential (CMAP) amplitude (Amp), and distal motor latency (DML). SPSS 25.0 was used for statistical analysis. Results TCSS evaluation revealed that the percentage of patients with severe nerve injury was significantly higher in FMD<4% (70%) compared to FMD>7% (2%). Among the TCSS indicators of all subjects, the proportion of temperature disturbance was the most (73%), and joint position disturbance was the least (0). TCSS scores were negatively correlated with FMD ( r=−0.756, p<0.001 ). More interesting, in FMD<4% group, CV and Amp were positively correlated with FMD, while DML was negatively correlated ( p<0.05 ). Linear regression analysis model showed that different systolic blood pressure (SBP), triglyceride (TG), TCSS and CV had statistically different effects on FMD. Conclusion High TCSS score and decreased CV of common peroneal and tibial nerves are risk factors of FMD injury, which provide potential value for timely prevention and treatment of cardiovascular diseases.

Nerve conduction velocity is independently associated with bone mineral density in type 2 diabetes mellitus

“…The diabetes adults also have decreased levels of two sensory neuropeptides with bone anabolic activity, namely substance P and calcitonin gene-related peptide (CGRP) ( 50 ). In diabetes, peripheral neuropathy was associated with blood vessel damage ( 51 ) and abdominal obesity ( 52 ), which might mediate the interplay between DPN and bone disease. More clinical studies are needed to examine the association between DPN and bone disease in diabetes.…”

A Comprehensive Review on Bio-Based Materials for Chronic Diabetic Wounds

“…Organic compounds generated by living organisms are known as natural polymers or biopolymers [ 59 ]. An amino acid, monosaccharide, nucleoside, or ester can be made into a peptide, a polysaccharide, a polyphenol, and a polyester by covalently bonding these units together.…”