Abstract
Objective: To report a new marker for neuroinflammation in diabetic distal symmetric sensorimotor polyneuropathy.
Background A conduction slowing seldom fulfilling the AAN criteria for CIDP has been observed in diabetic distal symmetric sensorimotor polyneuropathy (DSP) in several studies.
Design/Methods: Urine secretory phopholipase activity (sPLA2) was measured in 34 DSP patients with at least one nerve conduction velocity (CV) slowing in the AAN demyelinating range (DSPs), 52 diabetic patients without CV slowing (DSPns), 5 diabetic patients without neuropathy (DWN) and 5 CIDP. Using multiple linear regression analysis, we related conduction velocity, (CV) ,distal latency (DL) and F latency to distal CMAP amplitude of median, ulnar, peroneal and tibial nerve in 76 patients with CIDP. The developed equations that assessed the range of slowing in CIDP were used to study conduction slowing in the above DSP patients.
Results: sPLA2 activity was significantly higher is the DSPs in nmol/min/ml (1411.2±281.09) and CIDP (1349.1 ±328.45) compared to controls (581.56±73.95) p<0.001. sPLA2 activity was significantly higher in DSPs group compared to DSPns group (892.91 128.28)p<0.001. However there was no significant difference in sPA2 activity between DSPns, DWN (835.66± 316.77) and control groups. In control group 95% of patients have an sPLA2 activity less than 1350 nmol/min/ml. 21 (54%) patients from DSPs and only 10(16%) patients from DSPns have at least two nerves with CV in the range predicted by the developed equations. Among the above patients 10 (30%) in the DSPs and only 1 (2%) DSPns patients have a sPLA2 activity more than 1350 nmol/min/ml.
Conclusions: Urine sPLA2 activity is significantly higher in DSPn compared to DSPns. When combined to CV slowing, it could be used as a marker of inflammatory demyelination in diabetic neuropathy.
Disclosure: Dr. Maybodi has nothing to disclose. Dr. Ende has nothing to disclose. Dr. Chen has nothing to disclose. Dr. Souayah has received personal compensation for activities with Walgreens as a consultant. Dr. Souayah has received research support from Talecris.
Tuesday, April 24 2012, 14:00 pm-18:30 pm
- Copyright © 2011 by AAN Enterprises, Inc.
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