Department of Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
Diabet Med. 2010 Mar;27(3):289-94. doi: 10.1111/j.1464-5491.2010.02940.x.
Osteoprotegerin (OPG) has been linked to different diabetes complications, including cardiovascular disease, and new findings have indicated a specific role in diabetic peripheral neuropathy, but the exact mechanism is unknown. To investigate a possible association between OPG and diabetic peripheral sensory neuropathy, we therefore analysed plasma OPG in Type 1 and Type 2 diabetic patients with and without peripheral neuropathy.
Two hundred Type 1 diabetes mellitus (T1DM) patients and 305 Type 2 diabetes mellitus (T2DM) patients participated in the study. Plasma OPG was measured with a sandwich immunoassay. Peripheral neuropathy was assessed by the Semmes-Weinstein monofilament test.
In T2DM, plasma OPG concentrations were significantly higher in the peripheral neuropathy group (P < 0.001). Furthermore, there was a significant relationship between the presence of neuropathy in T2DM and plasma OPG levels on logistic regression (P = 0.006). However, when investigated in a full multiple regression model including other long-term diabetes complications, the association became insignificant (P = 0.092). In T1DM, the difference in plasma OPG between groups did not reach significance (P = 0.066). However, plasma OPG significantly correlated to peripheral neuropathy in this group also (P = 0.022), although this correlation was not significant in a multiple linear regression model (P = 0.051).
Plasma OPG levels are related to peripheral neuropathy in both Type 1 and Type 2 diabetes, although with the strongest relationship in T2DM. Before understanding the significance of this, the pathological mechanism involved and, speculatively, a possible use of plasma OPG as a peripheral sensory neuropathy marker, a larger prospective study is needed.
骨保护素（OPG）与不同的糖尿病并发症有关，包括心血管疾病，新的研究结果表明其在糖尿病周围神经病变中具有特定作用，但确切的机制尚不清楚。为了研究 OPG 与糖尿病周围感觉神经病变之间的可能关联，我们分析了伴有和不伴有周围神经病变的 1 型和 2 型糖尿病患者的血浆 OPG。
本研究纳入了 200 例 1 型糖尿病（T1DM）患者和 305 例 2 型糖尿病（T2DM）患者。采用夹心免疫法测定血浆 OPG。通过 Semmes-Weinstein 单丝试验评估周围神经病变。
在 T2DM 中，周围神经病变组的血浆 OPG 浓度显著升高（P<0.001）。此外，在 logistic 回归分析中，T2DM 中存在神经病变与血浆 OPG 水平之间存在显著关系（P=0.006）。但是，当在包括其他长期糖尿病并发症的全多元回归模型中进行研究时，这种关联变得不显著（P=0.092）。在 T1DM 中，两组之间的血浆 OPG 差异无统计学意义（P=0.066）。然而，在该组中，血浆 OPG 与周围神经病变显著相关（P=0.022），尽管在多元线性回归模型中这种相关性不显著（P=0.051）。
血浆 OPG 水平与 1 型和 2 型糖尿病的周围神经病变有关，尽管在 T2DM 中相关性最强。在了解其意义、涉及的病理机制以及推测性地将血浆 OPG 作为周围感觉神经病变标志物的可能用途之前，需要进行更大规模的前瞻性研究。
