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Prediabetes, diabetes, metabolic syndrome, and small fiber neuropathy
Author(s) -
Thaisetthawatkul Pariwat,
Lyden Elizabeth,
Americo Fernandes J.,
Herrmann David N.
Publication year - 2020
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.26825
Subject(s) - prediabetes , sudomotor , medicine , skin biopsy , diabetes mellitus , nerve fiber , metabolic syndrome , axon reflex , abnormality , diabetic neuropathy , biopsy , peripheral neuropathy , dermatology , endocrinology , gastroenterology , reflex , type 2 diabetes , anatomy , psychiatry
This study was conducted to evaluate the association between prediabetes (PD), elements of the metabolic syndrome (MetS), and small fiber neuropathy (SFN). Methods A total of 268 patients with SFN symptoms and normal electrophysiology underwent tests to assess small fibers. SFN was diagnosed based on abnormality of at least two among intraepidermal nerve fiber density (IEFND), quantitative sensory testing, and quantitative sudomotor axon reflex testing. Results There was no difference in IENFD or abnormal skin biopsy frequency between PD and normoglycemia (NG). However, IENFD was lower in people with diabetes mellitus (DM) than in those with NG. An association between HbA1C and IENFD was observed only if DM patients were included. Attributes of the MetS were more common in those with an abnormal skin biopsy but not among those with autonomic dysfunction or meeting SFN criteria. Discussion DM, but not PD alone, is associated with SFN. Other MetS elements appear to preferentially impact small fiber structure over function.