D'Onofrio Luca, Ferdousi Maryam, Kalteniece Alise, Iqbal Zohaib, Petropoulos Ioannis N, Ponirakis Georgios, Buzzetti Raffaella, Malik Rayaz A, Soran Handrean
Department of Experimental Medicine, "Sapienza" University of Rome, Italy (Drs D'Onofrio and Buzzetti); NIHR/Wellcome Trust Clinical Research Facility, Manchester, UK (Drs D'Onofrio, Ferdousi, Kalteniece, and Soran).
NIHR/Wellcome Trust Clinical Research Facility, Manchester, UK (Drs D'Onofrio, Ferdousi, Kalteniece, and Soran); Department of Endocrinology, Diabetes and Metabolism, Peter Mount Building, Manchester University NHS Foundation Trust, Manchester, UK (Drs Ferdousi, Kalteniece, Iqbal, and Soran).
J Clin Lipidol. 2022 Jul-Aug;16(4):463-471. doi: 10.1016/j.jacl.2022.04.006. Epub 2022 Apr 30.
Hypertriglyceridemia has been identified as a risk factor for diabetic neuropathy.
Patients with hypertriglyceridemia underwent assessment of neuropathy and corneal confocal microscopy.
24 patients with severe hypertriglyceridemia defined as a triglyceride level more than 5.5 mmol/L (485 mg/dL) with no history of diabetes and 19 age-matched controls underwent assessment of HbA1c, blood pressure, fasting lipid profile, neuropathy disability score (NDS) and corneal confocal microscopy (CCM).
Patients with hypertriglyceridemia had a significantly higher NDS (P<0.001) and lower CNFD (no./mm) (27.1 [25.0-29.9] Vs 35.9 [31.2-40.6], p<0.001), CNBD (no./mm) (55.4±22.3 Vs 91.6±30.8, p<0.001), CNFL (mm/mm) (19.2±4.3 Vs 26.7±4.4, p<0.001) and IWL (mm/mm) (24.3±6.9 Vs 36.6±10.0, p<0.001) compared to control subjects. In subjects with hypertriglyceridemia serum triglyceride levels correlated with CNFD (rho= -0.473, p=0.002), CNBD (rho= -0.341, p=0.043), CNFL (rho= -0.446, p=0.006) and IWL (rho= -0.408, p=0.034), no correlation was found between triglycerides and CCM parameters in subjects without hypertriglyceridemia. Subjects with metabolic syndrome had a lower CNFD (32.3 [29.2-37.5] Vs 27.1 [20.8-30.2] no./mm, p=0.003), CNBD (20.1±6.0 Vs 23.9±5.3 no./mm, p=0.036), CNFL (57.7±26.9 Vs 79.2±32.6 mm/mm, p=0.037) and IWL (25.4±7.1 Vs 32.9±11.2 mm/mm, p=0.036) compared to subjects without metabolic syndrome.
Hypertriglyceridemia and metabolic syndrome are associated with small nerve fibre damage and clinical neuropathy. Elevated serum triglycerides may be a potential therapeutic target for the treatment of peripheral neuropathy.
高甘油三酯血症已被确认为糖尿病神经病变的一个危险因素。
对高甘油三酯血症患者进行神经病变评估及角膜共聚焦显微镜检查。
24例严重高甘油三酯血症患者（定义为甘油三酯水平超过5.5 mmol/L[485 mg/dL]且无糖尿病病史）和19例年龄匹配的对照者接受糖化血红蛋白、血压、空腹血脂谱、神经病变残疾评分（NDS）及角膜共聚焦显微镜检查（CCM）。
与对照者相比，高甘油三酯血症患者的NDS显著更高（P<0.001），而角膜神经纤维密度（CNFD，个/mm）更低（27.1[25.0 - 29.9]对35.9[31.2 - 40.6]，p<0.001）、角膜神经分支密度（CNBD，个/mm）更低（55.4±22.3对91.6±30.8，p<0.001）、角膜神经纤维长度（CNFL，mm/mm）更低（19.2±4.3对26.7±4.4，p<0.001）以及角膜内皮下神经纤维长度（IWL，mm/mm）更低（24.3±6.9对36.6±10.0，p<0.001）。在高甘油三酯血症患者中，血清甘油三酯水平与CNFD（rho = -0.473，p = 0.002）、CNBD（rho = -0.341，p = 0.043）、CNFL（rho = -0.446，p = 0.006）及IWL（rho = -0.408，p = 0.034）相关，而在无高甘油三酯血症的受试者中未发现甘油三酯与CCM参数之间存在相关性。与无代谢综合征的受试者相比，患有代谢综合征的受试者的CNFD更低（32.3[29.2 - 37.5]对27.1[20.8 - 30.2]个/mm，p = 0.003）、CNBD更低（20.1±6.0对23.9±5.3个/mm，p = 0.036）、CNFL更低（57.7±26.9对79.2±32.6 mm/mm，p = 0.037）及IWL更低（25.4±7.1对32.9±11.2 mm/mm，p = 0.036）。
高甘油三酯血症和代谢综合征与小神经纤维损伤及临床神经病变相关。血清甘油三酯升高可能是治疗周围神经病变的一个潜在治疗靶点。
