To investigate the associations between inflammation, oxidative stress, matrix metalloproteinases (MMPs), DNA damage, and the presence of distal symmetric diabetic polyneuropathy (DPNP) and diabetic neuropathic pain (DNP).
Approach:
Study Design: Prospective study involving 108 patients with Type 2 DM and 42 healthy controls.
Classification: Diabetic patients classified as having DPNP based on clinical and electrodiagnostic findings.
Evaluation: DNP evaluated using the Douleur Neuropathique 4 (DN4) questionnaire.
Biomarker Measurement: Serum levels of IL-6, TNF-α, IL-1β, MMP-2, MMP-9, MMP-10, OSI, and DNA damage were measured.
Key Findings:
Levels of IL-6, TNF-α, IL-1β, MMP-9, MMP-10, OSI, and DNA damage were significantly higher in diabetic patients compared to healthy controls (p < 0.001).
All biomarkers except MMP-2 were significantly elevated in diabetic patients with DPNP and DNP (p < 0.001).
Strong correlations were found among IL-6, TNF-α, IL-1β, MMP-9, and OSI levels.
Multivariable analysis showed DPNP was independently associated with increased levels of MMP-9, MMP-10, and OSI; DNP was associated with increased OSI levels.
Interpretation:
Limitations:
The study's cross-sectional design limits causal inferences.
The sample size may not be representative of the broader diabetic population.
