TY - JOUR

T1 - Increased levels of inflammatory factors are associated with severity of polyneuropathy in type 1 diabetes

AU - Okdahl, Tina

AU - Brock, Christina

AU - Floyel, Tina

AU - Wegeberg, Anne-Marie L.

AU - Jakobsen, Poul Erik

AU - Ejskjaer, Niels

AU - Pociot, Flemming

AU - Brock, Birgitte

AU - Storling, Joachim

PY - 2020

Y1 - 2020

N2 - Objective Distal symmetrical polyneuropathy (DSPN) is a severe common long-term complication of type 1 diabetes caused by impaired sensory-motor nerve function. As chronic low-grade inflammation may be involved in the pathogenesis of DSPN, we investigated the circulating levels of inflammatory markers in individuals with type 1 diabetes with and without DSPN. Furthermore, we determined to what extent these factors correlated with different peripheral sensory nerve functions. Design Cross-sectional study. Patients The study included 103 individuals with type 1 diabetes with (n = 50) and without DSPN (n = 53) as well as a cohort of healthy controls (n = 21). Measurements Circulating levels of various inflammatory markers (cytokines, chemokines and soluble adhesion molecules) were determined in serum samples by Luminex multiplexing technology. Peripheral sensory nerve testing, for example vibration, tactile and thermal perception, was assessed by standardized procedures. Results The cytokines IL-1 alpha, IL-4, IL-12p70, IL-13, IL-17A and TNF-alpha; the chemokine MCP-1; and the adhesion molecule E-selectin were significantly increased in individuals with type 1 diabetes with DSPN compared to those without DSPN (P < .001). These observations were independent of age, sex, BMI, disease duration and blood pressure. Additionally, higher serum concentrations of cytokines and chemokines were associated with higher vibration and tactile perception thresholds, but not with heat tolerance threshold. Conclusions Individuals with type 1 diabetes and concomitant DSPN display higher serum levels of several inflammatory markers. These findings support that systemic low-grade inflammation may play a role in the pathogenesis of DSPN.

AB - Objective Distal symmetrical polyneuropathy (DSPN) is a severe common long-term complication of type 1 diabetes caused by impaired sensory-motor nerve function. As chronic low-grade inflammation may be involved in the pathogenesis of DSPN, we investigated the circulating levels of inflammatory markers in individuals with type 1 diabetes with and without DSPN. Furthermore, we determined to what extent these factors correlated with different peripheral sensory nerve functions. Design Cross-sectional study. Patients The study included 103 individuals with type 1 diabetes with (n = 50) and without DSPN (n = 53) as well as a cohort of healthy controls (n = 21). Measurements Circulating levels of various inflammatory markers (cytokines, chemokines and soluble adhesion molecules) were determined in serum samples by Luminex multiplexing technology. Peripheral sensory nerve testing, for example vibration, tactile and thermal perception, was assessed by standardized procedures. Results The cytokines IL-1 alpha, IL-4, IL-12p70, IL-13, IL-17A and TNF-alpha; the chemokine MCP-1; and the adhesion molecule E-selectin were significantly increased in individuals with type 1 diabetes with DSPN compared to those without DSPN (P < .001). These observations were independent of age, sex, BMI, disease duration and blood pressure. Additionally, higher serum concentrations of cytokines and chemokines were associated with higher vibration and tactile perception thresholds, but not with heat tolerance threshold. Conclusions Individuals with type 1 diabetes and concomitant DSPN display higher serum levels of several inflammatory markers. These findings support that systemic low-grade inflammation may play a role in the pathogenesis of DSPN.

KW - cell adhesion molecules

KW - chemokines

KW - cytokines

KW - diabetes mellitus

KW - Type 1

KW - diabetic neuropathies

KW - inflammation mediators

KW - tactile perception

U2 - 10.1111/cen.14261

DO - 10.1111/cen.14261

M3 - Journal article

C2 - 32497255

VL - 93

SP - 419

EP - 428

JO - Clinical Endocrinology

JF - Clinical Endocrinology

SN - 0300-0664

IS - 4

ER -