Association between the Levels of IL-6, sE-Selectin and Distal Sensory Nerve Conduction Studies in Patients with Prediabetes

Abstract

Aim: To determine the association between interleukin-6 (IL-6) and soluble E-selectin (sE-selectin) levels with the electrodiagnostic abnormalities in patients with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). Methods: Serum HbA1c, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, IL-6 and sE-selectin levels were analyzed in 25 IFG patients, 22 IGT patients and 41 controls. Nerve conduction studies (NCS) of sural, dorsal sural (DS), medial dorsal cutaneous and medial plantar sensory nerves were conducted. Results: HbA1c and IL-6 levels were significantly higher in IFG and IGT patients than the controls. IGT patients had higher sE-selectin levels compared to controls and IFG patients. IL-6 levels were significantly correlated with levels of CRP, fibrinogen, ESR and sE-selectin in patients with prediabetes. Both IFG and IGT patients had substantial impairments in very distal sensory NCS. IL-6 levels were positively correlated with HbA1c and negatively correlated with DS NCS in prediabetic patients. Conclusions: Inflammation and endothelial dysfunction might be important in patients with IFG or IGT. Furthermore, our findings strengthen the idea that inflammation (increased levels of IL-6) might be associated with early electrophysiological impairments in patients with prediabetes. NCS of the most distal sensory nerves significantly enhanced the diagnosis of subclinical neuropathy in patients with prediabetes. Subclinical peripheral sensory neuropathy should be investigated in prediabetes to lower the number of future outcomes they are associated with.

Analysis of Inflammatory Cytokines in Pre-Diabetic Subjects

“…Another study reported an association between elevated levels of IL-6 and CRP and the risk of developing T2DM in the future and the link remained significant following adjustment for BMI, family history of diabetes, smoking, exercise and alcohol use using multivariate analysis [4]. More recently, studies have shown that HbA1c and IL-6 levels were significantly higher in IFG and IGT patients when compared to healthy individuals [11,12].…”

Corneal nerve loss in patients with TIA and acute ischemic stroke in relation to circulating markers of inflammation and vascular integrity

“…Recently, we have shown corneal nerve loss in patients with TIA 23 , acute ischemic stroke 24 – 27 and recurrent stroke 28 . Increased plasma adhesion molecules including P-selectin and ICAM-1 predict the development of diabetic neuropathy 29 and elevated IL-6 has been associated with distal neuropathy in subjects with impaired glucose tolerance 30 .…”

Corneal nerve loss in patients with TIA and acute ischemic stroke in relation to circulating markers of inflammation and vascular integrity

“…Recently, we have shown a signi cant loss of corneal nerves in patients with TIA [23], acute ischemic stroke [24][25][26] and recurrent stroke [27] indicating that it may be a surrogate marker for the risk of stroke. Increased plasma adhesion molecules including P-selectin and ICAM-1 predict the development of diabetic neuropathy over 5 years [28] and elevated IL-6 has been associated with distal neuropathy in subjects with impaired glucose tolerance [29].…”