Pasha Raabya, Kamath Anoushka, Linn Zara, Kalteniece Alise, Bashir Bilal, Schofield Jonathan D, Malik Rayaz, Azmi Shazli, Ferdousi Maryam, Soran Handrean
Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Manchester University NHS Foundation Trust, Manchester, UK.
Diabetes Obes Metab. 2025 Oct;27(10):5675-5682. doi: 10.1111/dom.16617. Epub 2025 Jul 24.
Dyslipidaemia contributes to the pathogenesis of diabetic peripheral neuropathy (DPN). While statins improve cardiovascular outcomes in diabetes, their potential neurotoxic effects remain debated. This study examined the impact of statin use on neuropathy in type 1 diabetes mellitus (T1DM).
Participants with T1DM (n = 160) and healthy controls (n = 64) underwent symptom and clinical evaluation of DPN, cardiac autonomic neuropathy (CAN) and corneal confocal microscopy (CCM). T1DM participants were stratified by statin use (non-statin: n = 68; statin treated: n = 92).
There were significant differences between the non-statin and statin patients with T1DM and healthy controls for the diabetic neuropathy symptom score (DNS) (0.49 ± 0.14 vs. 0.90 ± 0.13 vs. 0.15 ± 0.13, p < 0.001), neuropathy disability score (NDS) (2.55 ± 0.29 vs. 3.67 ± 0.26 vs. 0.44 ± 0.28, p < 0.001), vibration perception threshold (13.68 ± 1.16 vs. 16.03 ± 1.03 vs. 6.05 ± 1.08, p < 0.001), corneal nerve fibre density (19.61 ± 1.04 vs. 19.02 ± 0.92 vs. 28.48 ± 0.97, p < 0.001), branch density (20.40 ± 2.21 vs. 21.39 ± 1.94 vs. 37.31 ± 2.05, p < 0.001), fibre length (11.97 ± 0.51 vs. 11.51 ± 0.45 vs. 16.55 ± 0.47, p < 0.001), DB-HRV (26.27 ± 1.76 vs. 24.21 ± 1.51 vs. 30.18 ± 1.67, p = 0.033) and 30:15 ratio (1.32 ± 0.04 vs. 1.21 ± 0.03 vs. 1.15 ± 0.07, p = 0.033). Despite the statin group being significantly older (p < 0.001) with a higher BMI (p = 0.001) and longer duration of diabetes (p < 0.001), statin-treated patients showed no significant differences in most neuropathy measures, except DNS (p = 0.04), NDS (p = 0.009) and 30:15 ratio (p = 0.04).
This study demonstrates that individuals with T1DM exhibit neuropathic symptoms and disability, increased vibration perception thresholds, corneal nerve fibre loss and evidence of CAN. However, statin therapy was associated with comparable measures of DPN and CAN, despite statin-treated patients having a longer duration of diabetes and a higher BMI.
血脂异常促成糖尿病性周围神经病变（DPN）的发病机制。虽然他汀类药物可改善糖尿病患者的心血管结局，但其潜在的神经毒性作用仍存在争议。本研究探讨了他汀类药物的使用对1型糖尿病（T1DM）患者神经病变的影响。
T1DM患者（n = 160）和健康对照者（n = 64）接受了DPN、心脏自主神经病变（CAN）的症状及临床评估，以及角膜共聚焦显微镜检查（CCM）。T1DM患者根据是否使用他汀类药物分层（未使用他汀类药物：n = 68；使用他汀类药物治疗：n = 92）。
未使用他汀类药物的T1DM患者、使用他汀类药物治疗的T1DM患者和健康对照者之间，在糖尿病神经病变症状评分（DNS）（0.49±0.14 vs. 0.90±0.13 vs. 0.15±0.13，p < 0.001）、神经病变残疾评分（NDS）（2.55±0.29 vs. 3.67±0.26 vs. 0.44±0.28，p < 0.001）、振动觉阈值（13.68±1.16 vs. 16.03±
