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Subject Area

Dermatology

Article Type

Original Study

Abstract

Objectives To compare serum levels of tumor necrosis factor-alpha (TNF-α) in patients with peripheral neuropathy and patients without neuropathy in type 2 diabetes mellitus (T2DM) and study the relation between nerve conduction studies of motor and sensory nerves and the serum level of TNF-α in T2DM. Background TNF-α presence in the serum of diabetic patients can be used as an indicator for the development of neuropathy with nerve conduction studies. Patients and methods This cross-sectional study was conducted in diagnosed T2DM patients. They were divided into two groups: group I (n = 40) with clinically detectable diabetic peripheral neuropathy (DPN) of shorter duration and group II (n = 40) with clinically detectable DPN of longer duration. They were compared with patients without clinical neuropathy (n = 40); clinical diagnosis was based on Neurologic Severity Score (NSS) and National Disability Services (NDS) for signs. Blood samples were collected for the estimation of serum TNF-α. Nerve conduction velocity was measured in the upper and lower limbs. Median, ulnar, common peroneal, and posterior tibial nerves were selected for motor nerve conduction study and median and sural nerves were selected for sensory nerve conduction study. Results The serum level of TNF-α in type 2 diabetic patients with peripheral neuropathy is higher than those without neuropathy. The serum level of TNF-α shows statistically significant negative correlation with nerve conduction velocities which is higher in type 2 diabetic patients (5–10 years duration) with peripheral neuropathy. Conclusion A high level of TNF-α in the serum of T2DM patients with neuropathy shows possible contribution in the development of neuropathy. This cytokine might be used as a biomarker for DPN.

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