Uazman Alam1,2, Ioannis N Petropoulos3, Georgios Ponirakis3, Maryam Ferdousi4, Omar Asghar4, Maria Jeziorska4, Andrew Marshall5, Andrew J M Boulton4, Nathan Efron6, Rayaz A Malik3,4. 1. Department of Cardiovascular & Metabolic Medicine and the Pain Research Institute, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK. 2. Department of Diabetes, Endocrinology & Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. 3. Weill Cornell Medicine-Qatar, Research Division, Qatar Foundation, Doha, Qatar. 4. Institute of Cardiovascular Sciences, Cardiac Centre, Faculty of Medical and Human Sciences, University of Manchester and NIHR Clinical Research Facility, Manchester, UK. 5. Pain Research Institute, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK. 6. Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Abstract
BACKGROUND: The aetiology of painful diabetic neuropathy is unclear. We have evaluated vitamin D levels in diabetic patients with and without painful neuropathy. METHODS: Forty-three patients with type 1 diabetes and painless (DPN) (n = 20) or painful (PDN) (n = 23) neuropathy and 14 non-diabetic healthy control subjects (C) underwent assessment of neurologic deficits, quantitative sensory testing (QST), electrophysiology, skin biopsy, corneal confocal microscopy (CCM) and measurement of serum 25(OH)D. RESULTS: There were no significant differences for age, BMI, HbA1c , lipids, neurological deficits, QST, electrophysiology, intra-epidermal nerve fibre density (IENFD) and corneal nerve morphology between patients with DPN and PDN. Both positive (hyperalgesia and allodynia) and negative symptoms (paraesthesia and numbness) of diabetic neuropathy were greater in PDN compared with DPN (P = .009 and P = .02, respectively). Serum 25(OH)D levels were significantly lower in PDN (24.0 ± 14.1 ng/mL) compared with DPN (34.6 ± 15.0 ng/mL, P = .01) and controls (34.1 ± 8.6 ng/mL, P = .03). The odds ratio in favour of painful diabetic neuropathy was 9.8 [P = .003 (95% CI, 2.2-76.4)] for vitamin D deficiency (<20 ng/mL) and 4.4 [P = .03 (95% CI, 1.1-19.8)] for vitamin D insufficiency (<30 ng/mL). CONCLUSIONS: This study suggests that vitamin D deficiency and insufficiency are associated with painful diabetic neuropathy.
BACKGROUND: The aetiology of painful diabetic neuropathy is unclear. We have evaluated vitamin D levels in diabetic patients with and without painful neuropathy. METHODS: Forty-three patients with type 1 diabetes and painless (DPN) (n = 20) or painful (PDN) (n = 23) neuropathy and 14 non-diabetic healthy control subjects (C) underwent assessment of neurologic deficits, quantitative sensory testing (QST), electrophysiology, skin biopsy, corneal confocal microscopy (CCM) and measurement of serum 25(OH)D. RESULTS: There were no significant differences for age, BMI, HbA1c , lipids, neurological deficits, QST, electrophysiology, intra-epidermal nerve fibre density (IENFD) and corneal nerve morphology between patients with DPN and PDN. Both positive (hyperalgesia and allodynia) and negative symptoms (paraesthesia and numbness) of diabetic neuropathy were greater in PDN compared with DPN (P = .009 and P = .02, respectively). Serum 25(OH)D levels were significantly lower in PDN (24.0 ± 14.1 ng/mL) compared with DPN (34.6 ± 15.0 ng/mL, P = .01) and controls (34.1 ± 8.6 ng/mL, P = .03). The odds ratio in favour of painful diabetic neuropathy was 9.8 [P = .003 (95% CI, 2.2-76.4)] for vitamin D deficiency (<20 ng/mL) and 4.4 [P = .03 (95% CI, 1.1-19.8)] for vitamin D insufficiency (<30 ng/mL). CONCLUSIONS: This study suggests that vitamin D deficiency and insufficiency are associated with painful diabetic neuropathy.
Authors: Lilian de Souza D'Albuquerque Silva; Natércia Neves Marques de Queiroz; Franciane Trindade Cunha de Melo; João Felício Abrahão Neto; Luísa Corrêa Janaú; Norberto Jorge Kzan de Souza Neto; Manuela Nascimento de Lemos; Maria Clara Neres Iunes de Oliveira; Angélica Leite de Alcântara; Lorena Vilhena de Moraes; Wanderson Maia da Silva; Ícaro José Araújo de Souza; Nivin Mazen Said; Gabriela Nascimento de Lemos; Karem Miléo Felício; Márcia Costa Dos Santos; Ana Regina Bastos Motta; Melissa de Sá Oliveira Dos Reis; Isabel Jane Campos Lobato; Priscila Boaventura Barbosa de Figueiredo; Ana Carolina Contente Braga de Souza; Pedro Paulo Freire Piani; João Soares Felício Journal: Front Endocrinol (Lausanne) Date: 2020-11-19 Impact factor: 5.555
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Authors: Georgios Ponirakis; Tarik Elhadd; Ebaa Al Ozairi; Imad Brema; Subitha Chinnaiyan; Etab Taghadom; Jumana Al Kandari; Rehab Al Wotayan; Abdulla Al Ozairi; Naji Aljohani; Wael AlMistehi; Nora Al Qahtani; Shawana Khan; Zeinab Dabbous; Mashhood A Siddique; Ioannis N Petropoulos; Adnan Khan; Hamad Almuhannadi; Khaled Ae Ashawesh; Khaled M Dukhan; Ziyad R Mahfoud; Mahmoud A Zirie; Amin Jayyousi; Rayaz A Malik Journal: J Diabetes Investig Date: 2022-05-05 Impact factor: 3.681