Introduction: Diabetic neuropathy is the most prevalent complication of diabetes mellitus. Although the precise etiology of this neurological disorder has yet to be defined, elevated blood glucose promotes anerobic glycolysis; this produces excess advanced glycation end-products, many of which have a pyrrole structure. Here, we test the hypothesis that protein pyrrole adducts are associated with elevated glucose indices and some clinical features of diabetic diffuse neuropathies.
Method: We investigated the levels of plasma pyrrole adducts and adjusted urinary pyrrole adducts in a group of elderly persons (n = 516, age 60-79) residing in the District of Luohu, Shenzhen, China between 2017 and 2018. Symptoms of distal symmetric polyneuropathy (DSPN) and resting heart rate, a measure of autonomic nervous system function, were collected from participants (n = 258) with elevated glucose indices.
Result: Protein pyrrole adducts showed a strong correlation with glucose indices before and after adjustment for age and estimated glomerular filtration rates. Stratified analysis showed that the medians and interquartile values of pyrrole adducts grew as glucose indices of the subgroups increased. Participants with symptoms of DSPN and sinus tachycardia presented elevated levels of plasma pyrrole adducts.
Conclusion: This study provides a novel link between glucose indices and the etiology of diabetic diffuse neuropathies.
背景: 糖尿病神经病变是糖尿病最常见的并发症。虽然这种神经系统疾病的确切病因尚未确定，但血糖升高会促进无氧糖酵解, 这会产生过量的糖基化终产物，其中许多具有吡咯结构。在本文中，我们探究了吡咯蛋白加合物与血糖指数升高和糖尿病弥漫性神经病的一些临床特征的相关性。 方法: 我们调查了2017年至2018年间居住在中国深圳罗湖区的一组老年人(n = 516，年龄 60-79)的血浆吡咯加合物和校正尿吡咯加合物的水平。从血糖指数升高的参与者 (n=258) 中收集远端对称性多发性神经病(DSPN)的症状以及静息心率(衡量自主神经系统功能的指标)。 结果: 蛋白质吡咯加合物在校正年龄和估计肾小球滤过率前后与葡萄糖指数有很强的相关性。分层分析表明，吡咯加合物的中位数和四分位数随着亚组葡萄糖指数的增加而增加。有 DSPN 和窦性心动过速症状的参与者血浆吡咯加合物水平升高。 结论: 本研究提供了血糖指数与糖尿病弥漫性神经病病因学之间的新关联。.
Keywords: axonopathy; diabetic neuropathy; gamma-diketone; protein pyrrole adduct; γ-二酮; 糖尿病性神经病变; 蛋白质吡咯加合物; 轴突病.
© 2022 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai JiaoTong University School of Medicine and John Wiley & Sons Australia, Ltd.