Literature DB >> 35136815

Serum calprotectin: A marker for early diagnosis of diabetic peripheral neuropathy.

Mahesh Kumar Balasundaram1, Pranav G Sheth1, Alok Singh1.   

Abstract

Entities:  

Year:  2021        PMID: 35136815      PMCID: PMC8797086          DOI: 10.4103/jfmpc.jfmpc_891_21

Source DB:  PubMed          Journal:  J Family Med Prim Care        ISSN: 2249-4863


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We read the article with great curiosity titled the “Association of serum calprotectin with peripheral neuropathy in patients with type 2 diabetes mellitus” published in your esteemed journal.[1] The long-standing diabetes mellitus is complicated by microvascular complications like retinopathy, peripheral neuropathy, etc.[2] Diabetic peripheral neuropathy (DPN) is a unique microvascular complication as its early manifestations often go unnoticed until the disease is well established whereas diabetic retinopathy and nephropathy can be easily picked with the available tools. At the time of diagnosis, the damage that had occurred seems to be irreversible, hence, the early diagnosis of DPN is the key to prevent further damage to the neurons. An effective and simple diagnostic modality for early diagnosis of DPN is still a distant dream.[3] The prospective observational study aimed at finding the association between serum calprotectin and DPN in the South Indian population is indeed a milestone achievement. The accurate sample size calculation and usage of the receiver operating characteristic curve to show the utility of serum calprotectin as a diagnostic biomarker for DPN were added gems to the crown. The estimation of serum calprotectin using a two-step capture Enzyme-linked Immunosorbent Assay (ELISA) kit for accurate results is noteworthy. The exemplary research work still leaves a few questions unanswered and little confusion to be solved in the minds of avid readers. The inclusion criteria could have been redefined further. We could not understand whether both types 1 and 2 diabetic patients are included and the age criteria with the available demographic data. If the exclusion criteria were entirely made to recruit only the diabetic population to increase the precision of association between serum calprotectin and DPN, conditions like inflammatory bowel disease, Vitamin B12 deficiency, and spondyloarthritis could also have been excluded since the serum and fecal calprotectin estimation are well-known diagnostic modalities for inflammatory bowel disease.[4] The validity and internal consistency of the subgroup classification in the DPN group remain questionable as no reference was quoted for the same. If the classification was created by the authors, this should have been validated. In the Results section, the correlation of the body mass index (BMI) and serum calprotectin levels was tabulated but the details regarding the same were not mentioned anywhere in the methodology. It is quite disappointing for the readers as the authors failed to discuss the high levels of serum calprotectin in subclinical (n = 4) and underweight BMI categories (n = 2) when compared to the subgroups. This study indeed shines a ray of hope to the diabetic population as their most concerning problem could be identified at the earliest, thereby, preventing dreadful complications such as foot ulcers and lower-extremity amputations. Everything starts from a scratch, and with no further doubts, this study would make the distant dream of utilizing the serum calprotectin as an early diagnostic marker for DPN a dream come true in the near future.

Financial support and sponsorship

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Conflicts of interest

There are no conflicts of interest.
  3 in total

Review 1.  Diabetic peripheral neuropathy: advances in diagnosis and strategies for screening and early intervention.

Authors:  Dinesh Selvarajah; Debasish Kar; Kamlesh Khunti; Melanie J Davies; Adrian R Scott; Jeremy Walker; Solomon Tesfaye
Journal:  Lancet Diabetes Endocrinol       Date:  2019-10-14       Impact factor: 32.069

2.  Association of serum calprotectin with peripheral neuropathy in patients with type 2 diabetes mellitus.

Authors:  Ramanathan Velayutham; Pradeep Pankajakshan Nair; Prashant S Adole; Vadivelan Mehalingam
Journal:  J Family Med Prim Care       Date:  2021-04-29

Review 3.  The role of serum calprotectin as a novel biomarker in inflammatory bowel diseases: a review study.

Authors:  Tayebeh Azramezani Kopi; Shabnam Shahrokh; Shahrokh Mirzaei; Hamid Asadzadeh Aghdaei; Azade Amini Kadijani
Journal:  Gastroenterol Hepatol Bed Bench       Date:  2019
  3 in total

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