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Subclinical, vascular inflammation predict distal sensorimotor polyneuropathy
Clinical and vascular inflammation were predictive of the development and progression of distal sensorimotor polyneuropathy among older adults, according to researchers in Germany.
The data could be used to treat or prevent diabetic neuropathy, they wrote.
“Distal sensorimotor polyneuropathy is the most frequent neurological complication of type 2 diabetes,” Christian Herder, PhD, of the Institute for Clinical Diabetology at the German Diabetes Center, Dusseldorf, and colleagues wrote. “The pathomechanisms leading to the onset and progression of [distal sensorimotor polyneuropathy] are not completely understood, which profoundly limits current prevention and treatment.”
The researchers assessed the predictive value of eight biomarkers of inflammation for adults aged 62 to 81 years (n = 615). Mean follow-up was 6.5 years.
Herder and colleagues reported that many factors were associated with incident distal sensorimotor polyneuropathy after an age- and sex-adjusted analysis, including higher levels of soluble intercellular adhesion molecule, interleukin-1 receptor antagonist, tumor necrosis factor-alpha, IL-6 and high-sensitivity C-reactive protein, as well as lower adiponectin levels. Omentin and IL-18 were not associated with neuropathy, the researchers wrote. IL-1 receptor antagonist and soluble intercellular adhesion molecule were both associated with the progression of distal sensorimotor polyneuropathy.
IL-6 (OR = 1.31; 95% CI, 1-1.71) and tumor necrosis factor-alpha (OR = 1.31; 95% CI, 1.03-1.67) were associated with incident distal sensorimotor polyneuropathy, even after researchers adjusted for known risk factors. “The addition of both cytokines to a clinical risk model improved model fit and reclassification,” Herder and colleagues wrote.
“This population-based study demonstrated that subclinical inflammation precedes both the onset and the progression of [distal sensorimotor polyneuropathy],” the researchers wrote. “The combination with novel biomarkers reflecting other pathomechanisms contributing to [distal sensorimotor polyneuropathy] may be required to improve risk prediction at a clinically relevant level. The data further support the concept that modulation of inflammatory processes may be relevant to prevent and/or treat [distal sensorimotor polyneuropathy].” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.