(07-06-09) Elevated Triglycerides Correlate with Progression of Diabetic Neuropathy.

Wiggin TD, Sullivan KA, Pop-Busui R, Amato A, Sima AA, Feldman EL.
University of Michigan Department of Neurology.

Objective: To evaluate mechanisms underlying diabetic neuropathy
(DN) progression using indices of sural nerve morphometry obtained from two identical randomized placebo-controlled clinical trials. Research Design and Methods: Sural nerve myelinated fiber density (MFD), nerve conduction velocities, vibration perception thresholds, clinical symptom scores and a visual analogue scale for pain were analyzed in participants with DN. A loss of >/= 500 fibers/mm(2) in sural nerve MFD over 52 weeks was defined as progressing DN and a MFD loss of interval as non-progressing DN. The progressing and non-progressing cohorts were matched for baseline characteristics using an O'Brien rank sum and baseline MFD. Results: At 52 weeks, the progressing cohort demonstrated a 25% decrease (p < 0.0001) from baseline in MFD while the non-progressing cohort remained unchanged. MFD was not affected by active drug treatment (p=0.87), diabetes duration (p=0.48), age (p=0.11) or body mass index (BMI) (p=0.30).
Among all variables tested, elevated triglycerides and decreased peroneal motor NCV at baseline significantly correlated with loss of MFD at 52 weeks (p=0.04).
Conclusions: In this cohort of participants with mild/moderate DN, elevated triglycerides correlated with MFD loss independent of disease duration, age, diabetes control or other variables. These data support the evolving concept that hyperlipidemia is instrumental in the progression of DN.

Source: Diabetes. 2009 May 1.

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