Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2020; 11(7): 309-321
Published online Jul 15, 2020. doi: 10.4239/wjd.v11.i7.309
Relationship between diabetic polyneuropathy, serum visfatin, and oxidative stress biomarkers
Banu Buyukaydin, Eray Metin Guler, Tahsin Karaaslan, Atilla Olgac, Mehmet Zorlu, Muharrem Kiskac, Abdurrahim Kocyigit
Banu Buyukaydin, Atilla Olgac, Mehmet Zorlu, Muharrem Kiskac, Department of Internal Medicine, Bezmialem Vakif University Medical Faculty, İstanbul 34093, Turkey
Eray Metin Guler, Abdurrahim Kocyigit, Department of Medical Biochemistry, Bezmialem Vakif University Medical Faculty, İstanbul 34093, Turkey
Tahsin Karaaslan, Department of Nephrology, Istanbul Medeniyet University Medical Faculty, İstanbul 34093, Turkey
Author contributions: Buyukaydin B designed the study and wrote the paper; Guler EM performed research; Karaaslan T, Olgac A, Zorlu M, and Kiskac M participated in data collection and analysis; Kocyigit A interpreted the data and drafted the initial manuscript.
Institutional review board statement: The study was reviewed and approved by the Bezmiâlem Vakıf University Clinical Research Ethics Committee Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Banu Buyukaydin, MD, Academic Research, Doctor, Department of Internal Medicine, Bezmialem Vakif University Medical Faculty, Adnan Menderes Street, İstanbul 34093, Turkey. bbuyukaydin@hotmail.com
Received: December 30, 2019
Peer-review started: December 30, 2019
First decision: March 24, 2020
Revised: May 8, 2020
Accepted: May 12, 2020
Article in press: May 12, 2020
Published online: July 15, 2020
Abstract
BACKGROUND

Diabetic polyneuropathy is a very common complication of diabetes. Numerous studies are available in terms of pathogenesis. But examination methods with low reliability are still not standardized and generally time consuming. High-sensitive, easy-to-access methods are expected. Biochemical markers are one of the subjects of research. We aimed to discover a potential biomarker that can be used for this purpose in patients with diabetes who have not yet developed symptoms of neuropathy.

AIM

To determine the place and availability of visfatin and thiol-disulfide homeostasis in this disorder.

METHODS

A total of 392 patients with type 2 diabetes mellitus were included in the study. The polyneuropathy clinical signs were evaluated with the Subjective Peripheral Neuropathy Screen Questionnaire and Michigan Neuropathy Screening Instrument questionnaire and examination. The biochemical parameters, oxidative stress markers, visfatin, and thiol-disulfide homeostasis were analyzed and correlated with each other and clinical signs.

RESULTS

Subjective Peripheral Neuropathy Screen Questionnaire and Michigan Neuropathy Screening Instrument questionnaire with examination scores were correlated with each other and diabetes duration (P < 0.005). Neuropathy related symptoms were present in 20.7% of the patients, but neuropathy related findings were observed in 43.9% of the patients. Serum glucose, glycated hemoglobin, and visfatin were positively correlated with each other. Also, these parameters were positively correlated with the total oxidative stress index. Total and native thiol was positively correlated with total antioxidant status and negatively with oxidant status. Inversely thiol-disulfide positively correlated with higher glucose and oxidant status and negatively with total antioxidant status (P < 0.005). There was no correlation between visfatin and thiol-disulphide (P = 0.092, r = 0.086). However, a significant negative correlation was observed between visfatin and total with native thiol (P < 0.005, r = -0.338), (P < 0.005, r = -0.448).

CONCLUSION

Diagnosis of neuropathy is one of the issues studied in patients with diabetes. Visfatin and thiol-disulfide balance were analyzed for the first time in this study with inspiring results.

Keywords: Diabetic neuropathy, Diabetic foot, Early detection, Oxidative stress, Thiol-disulfide, Visfatin protein

Core tip: Early diagnosis and management of micro and macrovascular complications are vital in patients with diabetes. Many algorithms and early diagnostic tools have been developed for this purpose. Yet it is still difficult to identify neuropathy because of the prolonged preclinical phase. This patient group has uncontrolled blood sugar and hypertension, accelerated renal replacement need, and life-threatening cardiac or cerebral macrovascular complications. With this study, we wanted to emphasize that screening of neuropathy should not be ignored in the follow-up of these cases. As an early diagnostic tool, many parameters that are responsible for pathogenesis should be investigated.