Institute for Clinical Diabetology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany German Center for Diabetes Research (DZD), Düsseldorf, Germany
Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Institute for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Diabetes Care. 2015 Jan;38(1):91-6. doi: 10.2337/dc14-1403. Epub 2014 Oct 16.
Inflammatory processes have been implicated in the pathogenesis of painful neuropathy in rodents, but the relationship between inflammatory biomarkers and painful distal sensorimotor polyneuropathy (DSPN) has not been assessed in population-based studies. Therefore, we investigated whether circulating levels of seven pro- and anti-inflammatory immune mediators were associated with painful DSPN in older individuals in a large population-based study.
The study population consisted of individuals with painless (n = 337) and painful DSPN (n = 54) from a source population (n = 1,047) of men and women aged 61-82 years who participated in the German KORA F4 survey (2006-2008). We measured circulating levels of seven immune mediators and assessed their associations with the presence of painful DSPN using multiple logistic regression models.
After adjustment for age and sex, we found positive associations between serum concentrations of the cytokine interleukin (IL)-6 and the soluble intercellular adhesion molecule (sICAM)-1 and painful DSPN (P = 0.004 and P = 0.005, respectively), whereas no associations were observed for C-reactive protein, IL-18, tumor necrosis factor-α, adiponectin, and IL-1 receptor antagonist (IL-1RA, P = 0.07-0.38). Associations between IL-6 and sICAM-1 and painful DSPN remained significant after additional adjustment for waist circumference, height, hypertension, cholesterol, smoking, alcohol intake, physical activity, history of myocardial infarction and/or stroke, presence of other neurological conditions, and use of nonsteroidal anti-inflammatory drugs (P = 0.005 and P = 0.016, respectively).
Painful DSPN is linked to systemic subclinical and vascular inflammation in the older population independent of anthropometric, lifestyle, and metabolic confounders.
炎症过程与啮齿动物痛性神经病变的发病机制有关，但在基于人群的研究中，尚未评估炎症生物标志物与痛性远端感觉运动多发性神经病（DSPN）之间的关系。因此，我们在一项大型基于人群的研究中，调查了在老年人群中，七种促炎和抗炎免疫介质的循环水平是否与疼痛性 DSPN 相关。
研究人群包括来自一个男性和女性年龄在 61-82 岁的源人群（n = 1047）的无痛（n = 337）和痛性 DSPN（n = 54）个体。他们参加了德国 KORA F4 调查（2006-2008 年）。我们测量了七种免疫介质的循环水平，并使用多变量逻辑回归模型评估了它们与痛性 DSPN 存在的相关性。
在校正年龄和性别后，我们发现细胞因子白细胞介素（IL）-6 和可溶性细胞间黏附分子（sICAM）-1 的血清浓度与痛性 DSPN 呈正相关（P = 0.004 和 P = 0.005），而 C 反应蛋白、IL-18、肿瘤坏死因子-α、脂联素和 IL-1 受体拮抗剂（IL-1RA，P = 0.07-0.38）则无相关性。在校正腰围、身高、高血压、胆固醇、吸烟、饮酒、体力活动、心肌梗死和/或中风史、其他神经疾病和非甾体抗炎药的使用后，IL-6 和 sICAM-1 与痛性 DSPN 之间的相关性仍然显著（P = 0.005 和 P = 0.016）。
在老年人中，痛性 DSPN 与全身性亚临床和血管炎症有关，独立于人体测量、生活方式和代谢混杂因素。
