Metabolic syndrome and peripheral neuropathy

• Published in: Muscle & nerve 2021-03, Vol.63 (3), p.285-293
• Main Authors: Kazamel, Mohamed, Stino, Amro Maher, Smith, Albert Gordon
• Format: Article
• Language: English
• Subjects: Animal diseases; Animal models; Autonomic nervous system; Axons; Bariatric Surgery; cryptogenic sensory polyneuropathy, diabetic peripheral neuropathy, dyslipidemia, hypertriglyceridemia, metabolic syndrome, prediabetes, small‐fiber neuropathy; Diabetes mellitus (insulin dependent); Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - metabolism; Diabetes Mellitus, Type 1 - therapy; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - therapy; Diabetic Neuropathies - diagnosis; Diabetic Neuropathies - etiology; Diabetic Neuropathies - physiopathology; Diabetic Neuropathies - therapy; Diet Therapy; Disease Progression; Dyslipidemia; Dyslipidemias - epidemiology; Dyslipidemias - metabolism; Dyslipidemias - therapy; Epidemiology; Exercise; Fibers; Global health; Humans; Hypoglycemic Agents - therapeutic use; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Metabolic Syndrome - metabolism; Metabolic Syndrome - therapy; Obesity - epidemiology; Obesity - metabolism; Obesity - therapy; Pathogenesis; Peripheral Nervous System Diseases - diagnosis; Peripheral Nervous System Diseases - epidemiology; Peripheral Nervous System Diseases - physiopathology; Peripheral Nervous System Diseases - therapy; Peripheral neuropathy; Prediabetic State - diagnosis; Prediabetic State - epidemiology; Prediabetic State - metabolism; Public health; Quality of life; Risk; Risk Factors; Small Fiber Neuropathy - diagnosis; Small Fiber Neuropathy - epidemiology; Small Fiber Neuropathy - physiopathology; Small Fiber Neuropathy - therapy; Topiramate - therapeutic use
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.27086

Diabetic peripheral neuropathy and metabolic syndrome (MetS) are both global health challenges with well‐established diagnostic criteria and significant impacts on quality of life. Clinical observations, epidemiologic evidence, and animal models of disease have strongly suggested MetS is associated with an elevated risk for cryptogenic sensory peripheral neuropathy (CSPN). MetS neuropathy preferentially affects small unmyelinated axons early in its course, and it may also affect autonomic and large fibers. CSPN risk is linked to MetS and several of its components including obesity, dyslipidemia, and prediabetes. MetS also increases neuropathy risk in patients with established type 1 and type 2 diabetes. In this review we present animal data regarding the role of inflammation and dyslipidemia in MetS neuropathy pathogenesis. Several studies suggest exercise‐based lifestyle modification is a promising treatment approach for MetS neuropathy.