NSE, a Potential Biomarker, Is Closely Connected to Diabetic Peripheral Neuropathy

Abstract

OBJECTIVETo explore the relationship between serum neuron-specific enolase (NSE) levels and diabetic neuropathy.RESEARCH DESIGN AND METHODSType 1 or 2 diabetic and healthy control subjects (n = 568) were randomly enrolled in a cross-sectional study. Diabetic neuropathy status was documented by the presence of clinical symptoms or signs, electromyography, quantitative sensory tests, and cardiac autonomic neuropathy tests. The severity of the neuropathy was staged by composite scores. Serum NSE was measured using electrochemiluminescence immunoassay. The demographic and clinical variables were obtained through an interviewer questionnaire.RESULTSSerum NSE levels increased slightly in diabetic subjects compared with normal subjects (9.1 [1.5] vs. 8.7 [1.7], P = 0.037), and the levels increased greatly in diabetic subjects with neuropathy compared with those without (10.8 [2.8] vs. 9.1 [1.5], P = 0.000). The association of NSE with diabetic neuropathy was independent of the hyperglycemic state (fasting blood glucose, HbA1c, duration, and the type of diabetes) and other potential confounders affecting NSE levels (e.g., age, sex, and renal status) (odds ratio 1.48 [1.13–1.74], P = 0.001). In addition, NSE levels increased with and were closely correlated to the stages of neuropathy (r = 0.63 [0.52–0.74], P = 0.000). The optimal cutoff point for serum NSE levels to distinguish patients with diabetic neuropathy from those without was 10.10 μg/L, with a sensitivity of 66.3% and a specificity of 72.5%.CONCLUSIONSSerum NSE levels are closely associated with peripheral neuropathy in patients with diabetes. Future studies are warranted to clarify the relationship.

Serum neuron‐specific enolase is elevated as a novel indicator of diabetic retinopathy including macular oedema

“…Furthermore, NSE levels increased with stage of retinopathy and macular oedema, and were significantly correlated. Interestingly, the overall cut-off value for an indication of diabetic retinopathy, including macular, was slightly lower than our previously reported value for diabetic peripheral neuropathy [12]. HbA 1c is first reported in mmol/mol, followed by % in parentheses.…”

“…We also excluded other nervous system disorders including diabetic peripheral neuropathy and diseases reported to cause elevated serum enolase [12,[18][19][20][21][22]. We also excluded other nervous system disorders including diabetic peripheral neuropathy and diseases reported to cause elevated serum enolase [12,[18][19][20][21][22].…”

First Evidence For Glial Pathology In Late Life Minor Depression: s100b Is Increased In Males With Minor Depression

“…NSE, a peripheral marker of neuronal damage, might be either of central (Cheng et al, 2014) or peripheral origin (Li et al, 2013). In major depression a central origin is suggested by the correlation with white matter hyperintensities.…”

“…For instance, various subtypes of leukocytes can secrete S100B (Miki et al, 2013;Fujiya et al, 2014;Moutsatsou et al, 2014). Thrombocytes are the largest source for serum BDNF (Fujimura et al, 2002), adipocytes produce both S100B and BDNF (Fujiya et al, 2014;Huang et al, 2014), finally NSE may originate from damaged peripheral nerves (Li et al, 2013). Because we did not assume relevant biases related to these potentially confounding sources in minor depression, we did not control for potential non-brain sources of the serum markers in our study.…”

A Randomized, Sham-Controlled, Double-Blind Pilot Study of Pulsed Electromagnetic Field Therapy to Evaluate Small Fiber Nerve Growth and Function and Skin Perfusion in Subjects with Painful Peripheral Diabetic Neuropathy

“…While distal microcirculation of the hallux has been demonstrated to decrease in healthy subjects and those with Type 2 diabetes and intact skin, blood flow velocity on the dorsal foot significantly increased. This may have occurred due to differences in capillary density or due to a local "steal phenomenon" caused by vasodilation of the more proximal medium sized arterioles [35][36][37]. In subjects with a diabetic foot ulceration, distal hallux microcirculation increased after 14 sessions of one hour daily PEMF therapy performed over three-week timeframe.…”