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脂联素、亚临床炎症标志物与新诊断的1型和2型糖尿病患者的神经传导

Adiponectin, markers of subclinical inflammation and nerve conduction in individuals with recently diagnosed type 1 and type 2 diabetes.

作者信息

Schamarek Imke, Herder Christian, Nowotny Bettina, Carstensen-Kirberg Maren, Straßburger Klaus, Nowotny Peter, Strom Alexander, Püttgen Sonja, Müssig Karsten, Szendroedi Julia, Roden Michael, Ziegler Dan

机构信息

Institute for Clinical DiabetologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, GermanyGerman Center for Diabetes ResearchMünchen-Neuherberg, GermanyInstitute for Biometrics and EpidemiologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, GermanyDepartment of Endocrinology and DiabetologyMedical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany Institute for Clinical DiabetologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, GermanyGerman Center for Diabetes ResearchMünchen-Neuherberg, GermanyInstitute for Biometrics and EpidemiologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, GermanyDepartment of Endocrinology and DiabetologyMedical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.

Institute for Clinical DiabetologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, GermanyGerman Center for Diabetes ResearchMünchen-Neuherberg, GermanyInstitute for Biometrics and EpidemiologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, GermanyDepartment of Endocrinology and DiabetologyMedical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany Institute for Clinical DiabetologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225 Düsseldorf, GermanyGerman Center for Diabetes ResearchMünchen-Neuherberg, GermanyInstitute for Biometrics and EpidemiologyGerman Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, GermanyDepartment of Endocrinology and DiabetologyMedical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany

出版信息

Eur J Endocrinol. 2016 Apr;174(4):433-43. doi: 10.1530/EJE-15-1010. Epub 2016 Jan 5.

Abstract

OBJECTIVE

Subclinical inflammation has been implicated in the development of diabetic sensorimotor polyneuropathy (DSPN), but studies using electrophysiological assessment as outcomes are scarce. Therefore, we aimed to investigate associations of biomarkers reflecting different aspects of subclinical inflammation with motor and sensory nerve conduction velocity (NCV) in individuals with diabetes.

DESIGN AND METHODS

Motor and sensory NCV was assessed in individuals with recently diagnosed type 2 (n=352) or type 1 diabetes (n=161) from the baseline cohort of the observational German Diabetes Study. NCV sum scores were calculated for median, ulnar and peroneal motor as well as median, ulnar and sural sensory nerves. Associations between inflammation-related biomarkers, DSPN and NCV sum scores were estimated using multiple regression models.

RESULTS

In type 2 diabetes, high serum interleukin (IL)-6 was associated with the presence of DSPN and reduced motor NCV. Moreover, higher levels of high-molecular weight (HMW) adiponectin, total adiponectin and their ratio were associated with prevalent DSPN and both diminished motor and sensory NCV, whereas no consistent associations were observed for C-reactive protein, IL18, soluble intercellular adhesion molecule-1 and E-selectin. In type 1 diabetes, only HMW and total adiponectin showed positive associations with motor NCV.

CONCLUSIONS

Our results point to a link between IL6 and both DSPN and slowed motor NCV in recently diagnosed type 2 diabetes. The reverse associations between adiponectin and NCV in type 1 and type 2 diabetes are intriguing, and further studies should explore whether they may reflect differences in the pathogenesis of DSPN in both diabetes types.

摘要

目的

亚临床炎症与糖尿病性感觉运动性多发性神经病变(DSPN)的发生有关,但以电生理评估作为结果的研究较少。因此,我们旨在研究反映亚临床炎症不同方面的生物标志物与糖尿病患者运动和感觉神经传导速度(NCV)之间的关联。

设计与方法

在德国糖尿病观察性研究的基线队列中,对最近诊断为2型糖尿病(n = 352)或1型糖尿病(n = 161)的个体进行运动和感觉NCV评估。计算正中神经、尺神经和腓总神经运动以及正中神经、尺神经和腓肠神经感觉的NCV总和评分。使用多元回归模型估计炎症相关生物标志物、DSPN和NCV总和评分之间的关联。

结果

在2型糖尿病中,高血清白细胞介素(IL)-6与DSPN的存在和运动NCV降低有关。此外,高分子量(HMW)脂联素、总脂联素及其比值较高与DSPN的患病率以及运动和感觉NCV降低均有关,而未观察到C反应蛋白、IL18、可溶性细胞间黏附分子-1和E选择素的一致关联。在1型糖尿病中,只有HMW和总脂联素与运动NCV呈正相关。

结论

我们的结果表明,在最近诊断的2型糖尿病中,IL6与DSPN和运动NCV减慢之间存在联系。1型和2型糖尿病中脂联素与NCV之间的反向关联很有趣,进一步的研究应探讨它们是否可能反映两种糖尿病类型中DSPN发病机制的差异。

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