Can Glycosylated Hemoglobin and C-reactive Protein Levels Predict Development of Subclinical Neuropathy in Pre-diabetics?
Journal Title: International Neuropsychiatric Disease Journal - Year 2016, Vol 6, Issue 2
Abstract
Background: Individuals with elevated glycosylated hemoglobin (HbA1c) have a higher rate of microvascular complications, especially peripheral neuropathy. Objective: To find the relation between elevated (HbA1c) and the occurrence of peripheral nerve dysfunction in prediabetic individuals and to find the role of the inflammatory marker as, C-Reactive Protein (CRP), in the development of Diabetic Peripheral Neuropathy (DPN). Methods: Screening was done for 80 pre-diabetic individuals and 40 control subjects presenting to the internal medicine clinics, Mansoura University Hospital; Egypt, from August 2014 to July 2015. The pre-diabetic individuals (HBA1c: 6.0-6.5%) and a control group of 40 subjects with HbA1c < 6%. All subjects underwent neurological examination, nerve conduction study of both peroneal and sural nerves, and measurement of HbA1c and CRP. Results: The sural nerve Sensory Nerve Action Potential (SNAP) amplitude was significantly lower in pre-diabetics than in control group. Compound Muscle Action Potential (CMAP) of the peroneal nerve was lower significantly in pre-diabetics with subclinical neuropathy in comparison to controls. The peroneal and sural nerve amplitudes were significantly correlated to CRP, but not to HbA1c. Conclusion: Axonal subclinical neuropathy occurs significantly more in pre-diabetics than in normal (control) individuals. The CRP is significantly correlated with the presence of the axonal subclinical neuropathy which indicates an underlying inflammatory role.
Authors and Affiliations
Ahmed Esmael, Mohammad Abu-Hegazy, Amr Elrabat
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