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Sorbitol and myo-inositol levels and morphology of sural nerve in relation to peripheral nerve function and clinical neuropathy in men with diabetic, impaired, and normal glucose tolerance

Sundkvist, Göran LU ; Dahlin, L. B. LU ; Nilsson, H. LU ; Eriksson, K. F. LU ; Lindgärde, F. LU ; Rosén, I. LU ; Lattimer, S. A. ; Sima, A. A.F. ; Sullivan, K. and Greene, D. A. (2000) In Diabetic Medicine 17(4). p.259-268
Abstract

Aims: Sorbitol and myo-inositol levels and morphology of sural nerve were compared with nerve function and clinical neuropathy in men with diabetic, impaired (IGT), and normal glucose tolerance. Methods: After neurography of sural nerve and determinations of sensory thresholds for vibration, warm and cold on the foot, whole nerve sural nerve biopsy was performed in 10 men with Type 1 diabetes mellitus, 10 with IGT, and 10 with normal glucose tolerance. Polyol levels were assessed by gas-liquid chromatography/mass spectrometry. Results: Sural nerve amplitudes were significantly lower and sorbitol levels significantly higher in diabetic patients (median (interquartile range)) (3.7 (3.5) μV and 643 (412) pmol/mg protein, respectively) both... (More)

Aims: Sorbitol and myo-inositol levels and morphology of sural nerve were compared with nerve function and clinical neuropathy in men with diabetic, impaired (IGT), and normal glucose tolerance. Methods: After neurography of sural nerve and determinations of sensory thresholds for vibration, warm and cold on the foot, whole nerve sural nerve biopsy was performed in 10 men with Type 1 diabetes mellitus, 10 with IGT, and 10 with normal glucose tolerance. Polyol levels were assessed by gas-liquid chromatography/mass spectrometry. Results: Sural nerve amplitudes were significantly lower and sorbitol levels significantly higher in diabetic patients (median (interquartile range)) (3.7 (3.5) μV and 643 (412) pmol/mg protein, respectively) both compared with IGT (11.3 (10.6) μV; P = 0.04 and 286 (83) pmol/mg protein; P = 0.0032, respectively) and normally glucose tolerant (10.0 (11.6); P = 0.0142 and 296 (250) pmol/mg protein; P = 0.0191, respectively) subjects. There were no differences in nerve morphology between the three groups. Nerve myo-inositol levels correlated, however, positively with cluster density (r(s) = 0.56; P = 0.0054). In diabetic and IGT subjects, sural nerve amplitudes (2.6 (3.8) vs. 12.1 (10.6) μV; P = 0.0246) and myelinated nerve fibre density (MNFD; 4076 (1091) vs. 5219 (668) nerve fibres/mm2; P = 0.0021) were significantly lower in nine subjects with clinical neuropathy than in 10 without. Conclusions: Nerve degeneration (i.e. MNFD) correlated with clinical neuropathy but not with glucose tolerance status whereas nerve myo-inositol levels positively correlated with signs of nerve regeneration (i.e. increased cluster density).

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Human diabetes, IGT, Peripheral nerve function, Sorbitol, Sural nerve
in
Diabetic Medicine
volume
17
issue
4
pages
259 - 268
publisher
Wiley-Blackwell
external identifiers
  • scopus:0034026555
  • pmid:10821291
ISSN
0742-3071
DOI
10.1046/j.1464-5491.2000.00261.x
language
English
LU publication?
yes
id
c48d1cf2-467c-4241-8542-52ee2a455ff4
date added to LUP
2019-06-17 14:00:09
date last changed
2020-01-16 03:59:01
@article{c48d1cf2-467c-4241-8542-52ee2a455ff4,
  abstract     = {<p>Aims: Sorbitol and myo-inositol levels and morphology of sural nerve were compared with nerve function and clinical neuropathy in men with diabetic, impaired (IGT), and normal glucose tolerance. Methods: After neurography of sural nerve and determinations of sensory thresholds for vibration, warm and cold on the foot, whole nerve sural nerve biopsy was performed in 10 men with Type 1 diabetes mellitus, 10 with IGT, and 10 with normal glucose tolerance. Polyol levels were assessed by gas-liquid chromatography/mass spectrometry. Results: Sural nerve amplitudes were significantly lower and sorbitol levels significantly higher in diabetic patients (median (interquartile range)) (3.7 (3.5) μV and 643 (412) pmol/mg protein, respectively) both compared with IGT (11.3 (10.6) μV; P = 0.04 and 286 (83) pmol/mg protein; P = 0.0032, respectively) and normally glucose tolerant (10.0 (11.6); P = 0.0142 and 296 (250) pmol/mg protein; P = 0.0191, respectively) subjects. There were no differences in nerve morphology between the three groups. Nerve myo-inositol levels correlated, however, positively with cluster density (r(s) = 0.56; P = 0.0054). In diabetic and IGT subjects, sural nerve amplitudes (2.6 (3.8) vs. 12.1 (10.6) μV; P = 0.0246) and myelinated nerve fibre density (MNFD; 4076 (1091) vs. 5219 (668) nerve fibres/mm<sup>2</sup>; P = 0.0021) were significantly lower in nine subjects with clinical neuropathy than in 10 without. Conclusions: Nerve degeneration (i.e. MNFD) correlated with clinical neuropathy but not with glucose tolerance status whereas nerve myo-inositol levels positively correlated with signs of nerve regeneration (i.e. increased cluster density).</p>},
  author       = {Sundkvist, Göran and Dahlin, L. B. and Nilsson, H. and Eriksson, K. F. and Lindgärde, F. and Rosén, I. and Lattimer, S. A. and Sima, A. A.F. and Sullivan, K. and Greene, D. A.},
  issn         = {0742-3071},
  language     = {eng},
  number       = {4},
  pages        = {259--268},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Sorbitol and myo-inositol levels and morphology of sural nerve in relation to peripheral nerve function and clinical neuropathy in men with diabetic, impaired, and normal glucose tolerance},
  url          = {http://dx.doi.org/10.1046/j.1464-5491.2000.00261.x},
  doi          = {10.1046/j.1464-5491.2000.00261.x},
  volume       = {17},
  year         = {2000},
}