Proinflammatory cytokines predict the incidence of diabetic peripheral neuropathy over 5 years in Chinese type 2 diabetes patients: A prospective cohort study.
ACR, albumin-to-creatinine ratio
ALT, alanine aminotransferase
AST, aspartate aminotransferase
DBP, diastolic blood pressure
DPN, diabetic peripheral neuropathy
DSPN, distal sensorimotor polyneuropathy
Diabetic peripheral neuropathy
FPG, fasting plasma glucose
HDL-C, high-density lipoprotein cholesterol
HbA1c, glycated hemoglobin
IL-1RA, interleukin-1 receptor antagonist
LDL-C, low-density lipoprotein cholesterol
MDRD, Modification of Diet in Renal Disease
MNSI, Michigan Neuropathy Screening Instrument
NLR, neutrophil-to-lymphocyte ratio
PPG, postprandial plasma glucose
Predict
Proinflammatory cytokines
SBP, systolic blood pressure
Scr, serum creatinine
TC, total cholesterol
TG, triacylglycerol
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
20
09
2020
revised:
30
10
2020
accepted:
30
10
2020
entrez:
1
1
2021
pubmed:
2
1
2021
medline:
2
1
2021
Statut:
epublish
Résumé
Inflammation has been implicated in the pathogenesis of diabetic peripheral neuropathy (DPN) as suggested in various cross-sectional studies. However, more convincing prospective studies in diabetes patients are scarce. Therefore, we aimed to evaluate whether proinflammatory cytokines could predict the incidence of DPN through a prospective study with a five-year follow-up. We followed up 315 patients with diabetes who did not have DPN, recruited from five community health centers in Shanghai in 2014, for an average of 5.06 years. Based on the integrity of blood samples, 106 patients were selected to obtain the proinflammatory cytokines. Plasma markers of proinflammatory cytokines at baseline included interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and intercellular adhesion molecule 1 (ICAM-1). Neuropathy was assessed by MSNI at baseline and during follow-up. Among the 106 chosen patients, 63 developed DPN after 5.06±1.14 years of follow-up. The baseline plasma levels of TNF-α, IL-6, and ICAM-1 were higher in the neuropathic group (p<0.05). In multivariate models, increased plasma levels of TNF-α (hazard ratio, HR: 8.74 [95% confidence interval, CI: 1.05-72.68]; Increased plasma levels of proinflammatory factors, especially TNF-α and ICAM-1, predicted the incidence of DPN over 5 years in Chinese diabetes patients, but larger longitudinal studies are required for confirmation. National Natural Science Foundation of China, Shanghai Talent Development Fund Program, Shanghai Shenkang Hospital Developing Center Clinical Scientific and Technological Innovation Program, Shanghai Science and Technology Committee Program, Shanghai General Hospital Program of Chinese traditional and Western medicine combination and Shanghai Municipal Commission of Health and Family Planning Clinical Research Project.
Sections du résumé
BACKGROUND
BACKGROUND
Inflammation has been implicated in the pathogenesis of diabetic peripheral neuropathy (DPN) as suggested in various cross-sectional studies. However, more convincing prospective studies in diabetes patients are scarce. Therefore, we aimed to evaluate whether proinflammatory cytokines could predict the incidence of DPN through a prospective study with a five-year follow-up.
METHODS
METHODS
We followed up 315 patients with diabetes who did not have DPN, recruited from five community health centers in Shanghai in 2014, for an average of 5.06 years. Based on the integrity of blood samples, 106 patients were selected to obtain the proinflammatory cytokines. Plasma markers of proinflammatory cytokines at baseline included interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vascular endothelial growth factor (VEGF), and intercellular adhesion molecule 1 (ICAM-1). Neuropathy was assessed by MSNI at baseline and during follow-up.
FINDINGS
RESULTS
Among the 106 chosen patients, 63 developed DPN after 5.06±1.14 years of follow-up. The baseline plasma levels of TNF-α, IL-6, and ICAM-1 were higher in the neuropathic group (p<0.05). In multivariate models, increased plasma levels of TNF-α (hazard ratio, HR: 8.74 [95% confidence interval, CI: 1.05-72.68];
INTERPRETATION
CONCLUSIONS
Increased plasma levels of proinflammatory factors, especially TNF-α and ICAM-1, predicted the incidence of DPN over 5 years in Chinese diabetes patients, but larger longitudinal studies are required for confirmation.
FUNDING
BACKGROUND
National Natural Science Foundation of China, Shanghai Talent Development Fund Program, Shanghai Shenkang Hospital Developing Center Clinical Scientific and Technological Innovation Program, Shanghai Science and Technology Committee Program, Shanghai General Hospital Program of Chinese traditional and Western medicine combination and Shanghai Municipal Commission of Health and Family Planning Clinical Research Project.
Identifiants
pubmed: 33385123
doi: 10.1016/j.eclinm.2020.100649
pii: S2589-5370(20)30393-X
pmc: PMC7772538
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100649Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors declare that there is no conflict of interest.
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