Increased plasma neurofilament light chain levels in patients with type-1 diabetes with impaired awareness of hypoglycemia

IntroductionImpaired awareness of hypoglycemia (IAH) is a common complication in patients with type-1 diabetes (T1D). IAH is a major risk factor for severe hypoglycemic events, leading to adverse clinical consequences and cerebral damage. Non-invasive, cost-effective, and logistically efficient biom...

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Published in:BMJ open diabetes research & care 2020-07, Vol.8 (1), p.e001516
Main Authors: Sampedro, Frederic, Stantonyonge, Nicole, Martínez-Horta, Saül, Alcolea, Daniel, Lleó, Alberto, Muñoz, Laia, Pérez-González, Rocío, Marín-Lahoz, Juan, Gómez-Ansón, Beatriz, Chico, Ana
Format: Article
Language:English
Subjects:
Biomarkers
Brain damage
Brain research
Diabetes
Glucose
Hypoglycemia
Insulin
Logistics
Medical imaging
Pathophysiology/Complications
Plasma
Sociodemographics
Variance analysis
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Summary:IntroductionImpaired awareness of hypoglycemia (IAH) is a common complication in patients with type-1 diabetes (T1D). IAH is a major risk factor for severe hypoglycemic events, leading to adverse clinical consequences and cerebral damage. Non-invasive, cost-effective, and logistically efficient biomarkers for this condition have not been validated. Here, we propose plasma neurofilament light chain (NfL) levels as a biomarker of neuroaxonal damage in patients with T1D-IAH.Research design and methods54 patients were included into the study (18 T1D-IAH, 18 T1D with normal awareness of hypoglycemia (NAH) and 18 healthy controls). We measured plasma NfL levels and studied cerebral gray matter alterations on MRI.ResultsWe found that NfL levels were increased in patients with T1D-IAH compared with patients with T1D-NAH and healthy controls. Importantly, increased NfL levels correlated with reduced cerebral gray matter volume and increased IAH severity in patients with T1D-IAH.ConclusionOverall, our findings identify plasma NfL levels as a potential biomarker of cerebral damage in this population, motivating further confirmatory studies with potential implications in clinical trials.
ISSN:2052-4897
2052-4897
DOI:10.1136/bmjdrc-2020-001516