Endocrine Abstracts

Background: Diabetic neuropathy is a widespread chronic diabetes complication. This heterogeneous group of conditions affects different parts of nervous system and presents with diverse clinical manifestations. Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes (T2DM), it may cause foot ulcer, gangrene or amputation. The risk of developing DPNincreases with age, diabetes duration and poor glycemia control. About 60% to 70% of all T2DM people will eventually develop DPN. Hypertiglyceridemia is a typical lipid disorder in patients with poorly controlled T2DM.

The Aim of this study was to assesseffect of hypertiglyceridemia on DPN in patient with T2DM.

Methods: In total, 62 T2DM patients with DPN(33 men and 29 women) were enrolled in the Study Group (SG). Their mean age was 56 ± 7 yrs and diabetes durationvaried from 5 to 10 yrs. In all SG patients hypertiglyceridemia was diagnosed. Anotherage, sex and diabetes duration matched 50 patients with normal triglycerides (TG) who had no DPN were used as controls (CG). HbA1c in SG was 8.1 ± 1.2% and inCG – 7.7 ± 1.1%. According to current Guidelines, to assess DPN following neuropathy tests were performed in all the patients: 10-g monofilament test, tip-term/temperature test, vibration test with 128-Hz tuning fork, prick test and neurological examination with Sudoscan, a non–invasive method forassessment of small fiber function (Impeto Medical, France). Results of all neurological tests in SG patients (monofilament, tip-term/temperature, prick, vibration tests) were positive, Sudoscan examination revealed presence of small fiber neuropathy. In CG patients all tests, except Sudoscan, were negative, while Sudoscan revealed small fiber damage. Association between hypertiglyceridemia and DPN was assessed. Serum triglyceride levels in SG patients were elevated (mean TG level 299 ± 45 mg/dl, while in CG patients they were100 ± 20 mg/dl).

Results: According to neurological examinations prevalence of DPN in SG comprised 64, 5% (40 cases). TG concentration was significantly higherin T2DM patients with DPN when compared to patients without DPN and normal TG levels (P = 0.005). Elevated serum triglyceride levels were associated with DPN (P < 0.044).

Conclusion: This study shows that increased serum triglyceride levelsmay play important clinical role in DPN development in patients with T2DM. The problem needs further investigation with the inclusion of other important parameters.