Subclinical Inflammation and Diabetic Polyneuropathy
MONICA/KORA Survey F3 (Augsburg, Germany)
- Christian Herder, PHD1,
- Mark Lankisch, MD2,
- Dan Ziegler, MD, FRCPE1,3,
- Wolfgang Rathmann, MD, MSPH4,
- Wolfgang Koenig, MD5,
- Thomas Illig, PHD6,
- Angela Döring, MD6,
- Barbara Thorand, PHD, MPH6,
- Rolf Holle, PHD7,
- Guido Giani, PHD4,
- Stephan Martin, MD1,8 and
- Christa Meisinger, MD, MPH6
- 1Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany;
- 2Department of Medicine III, Helios Clinic Wuppertal, Wuppertal, Germany;
- 3Department of Medicine/Metabolic Diseases, Heinrich Heine University Düsseldorf, Düsseldorf, Germany;
- 4Institute of Epidemiology and Biometrics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany;
- 5Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany;
- 6Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany;
- 7Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany;
- 8Sana Krankenhaus Gerresheim, Sana Kliniken Düsseldorf, Düsseldorf, Germany.
- Corresponding author: Christian Herder, christian.herder{at}ddz.uni-duesseldorf.de.
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C.H. and M.L. contributed equally to this study.
Abstract
OBJECTIVE Subclinical inflammation represents a risk factor of type 2 diabetes and several diabetes complications, but data on diabetic neuropathies are scarce. Therefore, we investigated whether circulating concentrations of acute-phase proteins, cytokines, and chemokines differ among diabetic patients with or without diabetic polyneuropathy.
RESEARCH DESIGN AND METHODS We measured 10 markers of subclinical inflammation in 227 type 2 diabetic patients with diabetic polyneuropathy who participated in the population-based MONICA/KORA Survey F3 (2004–2005; Augsburg, Germany). Diabetic polyneuropathy was diagnosed using the Michigan Neuropathy Screening Instrument (MNSI).
RESULTS After adjustment for multiple confounders, high levels of C-reactive protein and interleukin (IL)-6 were most consistently associated with diabetic polyneuropathy, high MNSI score, and specific neuropathic deficits, whereas some inverse associations were seen for IL-18.
CONCLUSIONS This study shows that subclinical inflammation is associated with diabetic polyneuropathy and neuropathic impairments. This association appears rather specific because only certain immune mediators and impairments are involved.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received November 7, 2008.
- Accepted January 3, 2009.
- © 2009 by the American Diabetes Association.
