The Relationship Between TNF-?,IL-6 And Peripheral Neuropathy In Impaired Glucose Regulation

Objective: In this study,we measured serum level of tumor necrosis factor alpha(TNF-?)and interleukin 6(IL-6)in normal control and IGR patients with or without peripheral neuropathy to explore the mechanism of TNF-? and IL-6 in the process of peripheral neuropathy.Correlation analysis of TNF-? and IL-6 with TCSS score in order to provide evidence for early diagnosis of IGR peripheral neuropathy.Methods: All of subjects were conformed with normal oral glucose tolerance test(OGTT)results.A total of 70 IGR patients received the conventional nerve conduction test,including 30 patients with peripheral neuropathy(PN),40 patients without peripheral neuropathy(NPN);The other 40 healthy were recruited as controls.The demographic data including height,weight,waist circumference,body mass index(BMI)and blood pressure was recorded in the 3 groups were recorded.Their Fasting blood glucose(FBG),glycosylated hemoglobin(Hb Alc),triglycerides(TG),total cholesterol(TC),high density lipoprotein(HDL-C),low density lipoprotein cholesterol(LDL-C)and high-sensitivity C-reactive protein(hs-CRP)were measured.Their serum TNF-? and IL-6 levels were measured by chemiluminescence method.The motor conduction of median nerve,ulnar nerve,common peroneal nerve,and the sensory conduction of median nerve,ulnar nerve,posterior tibial nerve,and sural nerve of all subjects were measured by the Dantec Keypoint Workstation.the severity of neuropathy were graded according to Toronto clinical scoring system(TCSS).Result:1.The serum TNF-? and IL-6 in IGR patients were higher than control group;And serum TNF-? and IL-6 levels in IGR-PN group were higher than IGR-NPN group(p<0.05).2.Multi factors logistic regression analysis showed that TNF-?(OR=0.893,p =0.009),IL-6(OR=0.876,p =0.041)were independent factors effecting whether IGR could combine with peripheral neuropathy.the neuropathy score in IGR-PN group was significantly higher IGR-NPN group with significant difference(p<0.01).3.The scores of TCSS in IGR-PN group and IGR-NPN group were significantly higher than those in control group(p <0.01),and the score of TCSS in IGR-PN group was significantly higher than that in IGR-NPN group(p <0.05),the difference was statistically significant.4.Neuropathy Comparison.Nerve conduction velocities in IGR-PN group were compared with IGR-NPN group.Motor nerve conduction velocities(MNCV)in common peroneal nerve and sensory nerve conduction velocities(SNCV)in posterior tibial nerve were significantly decreased(p < 0.05).Amplitudes in IGR-PN group were compared with IGR-NPN group.CMAP amplitude in common peroneal nerve and SNAP amplitude in median nerve and posterior tibial nerve were significantly decreased(p < 0.05).There was a significant negative correlation between SNCV and TCSS scores in sural neuropathy.5.Further Pearson correlation analysis showed TNF-? levels significantly positive related with TCSS score(r=0.331).6.Correlation of biomarker TNF-? with nerve conduction studies in IGR-PN group showed significant negative correlation with sural SNCV and posterior tibial nerve SNAP amplitude.Correlation of biomarker IL-6 with nerve conduction studies in IGR-PN group showed significant negative correlation with sural SNCV.Conclusion:1.TNF-? and IL-6 could aggregate peripheral neuropathy in impaired glucose regulation patients;2.TNF-? and IL-6 might be independent risk factors for peripheral neuropathy in glucose regulation impaired patients;3.TNF-? and IL-6 are associated with the degree of nerve damage induced by glucose regulated impaired;4.TNF-?,IL-6 may be a reliable biomarker for peripheral neuropathy in glucose regulation impaired patients.