Microvascular Reactivity and Inflammatory Cytokines in Painful and Painless Peripheral Diabetic Neuropathy
Microvascular Reactivity and Inflammatory Cytokines in Painful and Painless Peripheral Diabetic Neuropathy
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DOI：
10.1210/jc.2008-2385
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发表时间：
2009-06-01
影响因子：
5.8
通讯作者：
Veves, Aristidis
中科院分区：
文献类型：
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作者：
Doupis, John;Lyons, Thomas E.;Veves, Aristidis
目的：我们研究了炎症，微血管反应性，周围糖尿病neuropathy.Research设计和方法的发展之间的关联：我们研究了三组：55名健康对照组，80 nonneuropathic患者，和77神经病变糖尿病患者。我们还将神经病患者细分为31名无痛性神经病患者和46名疼痛性神经病患者。结果：神经病组内皮依赖性和非依赖性血管舒张功能、神经轴突反射相关性血管舒张功能（NARV）、炎性细胞因子及内皮功能生化指标均低于对照组（P < 0.05）。无痛性神经病变组NARV较痛性神经病变组进一步降低（P < 0.05）。与其他两组相比，神经病组的血清PDGF AA/BB水平也较高（P < 0.05），RANTES（P < 0.01），瘦素（P < 0.0001），骨保护素（P < 0.01）、G-CSF（P < 0.05）、sE-Selectin（P < 0.01）、sICAM（P <0.0001）、sVCAM（P <0.001）、CRP（P < 0.0001）、TNF α（P < 0.05）和纤维蛋白原（P < 0.05）。痛性神经病变组sICAM-1和CRP水平显著高于无痛性神经病变组（P < 0.05和P < 0.01）。在78例糖尿病患者中观察到的第二次访问21个月后，第一visit.Conclusions：周围糖尿病神经病变与炎症和内皮功能障碍的生化标志物增加，上述结果没有重大变化。疼痛性神经病变与炎症和内皮功能障碍标志物的进一步增加以及神经轴突反射的保留相关。（临床内分泌代谢杂志94：2157-2163，2009）
Objective: We investigated the association between inflammation, microvascular reactivity, and the development of peripheral diabetic neuropathy.Research Design and Methods: We studied three groups: 55 healthy control subjects, 80 nonneuropathic patients, and 77 neuropathic diabetic patients. We also subdivided the neuropathic patients into a subgroup of 31 subjects with painless neuropathy and 46 with painful neuropathy. We measured the foot skin endothelium-dependent and -independent vasodilation, the nerve axon reflex-related vasodilation (NARV), and inflammatory cytokines and biochemical markers of endothelial function.Results: The endothelium-dependent and -independent vasodilation and NARV were lower in the neuropathic group (P < 0.05). NARV was further reduced in the subgroup of painless neuropathy when compared to painful neuropathy (P < 0.05). Compared to the other two groups, the neuropathic group also had higher serum levels of PDGF AA/BB (P < 0.05), RANTES (P < 0.01), leptin (P < 0.0001), osteoprotegerin (P < 0.01), G-CSF (P < 0.05), sE-Selectin (P < 0.01), sICAM (P < 0.0001), sVCAM (P < 0.001), CRP (P < 0.0001), TNF alpha (P < 0.05), and fibrinogen (P < 0.05). Patients with painful neuropathy had higher sICAM-1 (P < 0.05) and CRP levels (P < 0.01) when compared to painless neuropathy. No major changes in the above results were observed in 78 diabetic patients who were seen for a second visit 21 months after the first visit.Conclusions: Peripheral diabetic neuropathy is associated with increased biochemical markers of inflammation and endothelial dysfunction. Painful neuropathy is associated with further increase in inflammation and markers of endothelial dysfunction and preservation of the nerve axon reflex. (J Clin Endocrinol Metab 94: 2157-2163, 2009)