The Relationship between Dyslipidemia and Acute Axonal Function in Type 2 Diabetes Mellitus In Vivo

• Published in: PloS one 2016-04, Vol.11 (4), p.e0153389-e0153389
• Main Authors: Kwai, Natalie C G, Nigole, William, Poynten, Ann M, Brown, Christopher, Krishnan, Arun V
• Format: Article
• Language: English
• Subjects: Age; Aged; Axons; Axons - metabolism; Biology and Life Sciences; Cholesterol; Cholesterol - blood; Clinical trials; Complications and side effects; Control data (computers); Data processing; Development and progression; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetic Neuropathies - physiopathology; Diabetic neuropathy; Dyslipidemia; Dyslipidemias; Dyslipidemias - complications; Dyslipidemias - diagnosis; Excitability; Excitation; Female; Genetic aspects; Glomerular Filtration Rate; Glycated Hemoglobin A - analysis; Hemoglobin; Humans; Hyperglycemia; Linear Models; Lipids; Lipoproteins; Lipoproteins, LDL - blood; Male; Medicine and Health Sciences; Metabolic disorders; Metabolic syndrome; Middle Aged; Nerve conduction; Neurophysiology; Pain; Patients; Peripheral neuropathy; Physical Sciences; Physiological aspects; Regression analysis; Renal function; Research and Analysis Methods; Risk factors; Rodents; Serum lipids; Studies; Target recognition; Triglycerides; Triglycerides - blood; Tumor necrosis factor-TNF; Type 2 diabetes
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0153389

Diabetic peripheral neuropathy (DPN) is a common and debilitating complication of diabetes mellitus. Treatment largely consists of symptom alleviation and there is a need to identify therapeutic targets for prevention and treatment of DPN. The objective of this study was to utilise novel neurophysiological techniques to investigate axonal function in patients with type 2 diabetes and to prospectively determine their relationship to serum lipids in type 2 diabetic patients. Seventy-one patients with type 2 diabetes were consecutively recruited and tested. All patients underwent thorough clinical neurological assessments including nerve conduction studies, and median motor axonal excitability studies. Studies were also undertaken in age matched normal control subjects(n = 42). Biochemical studies, including serum lipid levels were obtained in all patients. Patient excitability data was compared to control data and linear regression analysis was performed to determine the relationship between serum triglycerides and low density lipoproteins and excitability parameters typically abnormal in type 2 diabetic patients. Patient mean age was 64.2±2.3 years, mean glycosylated haemoglobin (HbA1c%) was 7.8±0.3%, mean triglyceride concentration was 1.6±0.1 mmol/L and mean cholesterol concentration was 4.1±0.2mmol/L. Compared to age matched controls, median motor axonal excitability studies indicated axonal dysfunction in type 2 diabetic patients as a whole (T2DM) and in a subgroup of the patients without DPN (T2DM-NN). These included reduced percentage threshold change during threshold electrotonus at 10-20ms depolarising currents (TEd10-20ms)(controls 68.4±0.8, T2DM63.9±0.8, T2DM-NN64.8±1.6%,P