Relationship between Hyponatremia and Peripheral Neuropathy in Patients with Diabetes

Objectives. Hyponatremia is a common complication of diabetes. However, the relationship between serum sodium level and diabetic peripheral neuropathy (DPN) is unknown. This study was aimed at investigating the relationship between low serum sodium level and DPN in Chinese patients with type 2 diabetes mellitus. Methods. A retrospective study was performed on 1928 patients with type 2 diabetes between 2010 and 2018. The multivariate test was used to analyze the relationship between the serum sodium level and the nerve conduction function. A restricted cubic spline was used to flexibly model and visualize the relationship between the serum sodium level and DPN, followed by logistic regression with adjustment. Results. As the serum sodium level increased, the prevalence of DPN had a reverse J-curve distribution with the serum sodium levels (69.6%, 53.7%, 49.6%, 43.9%, and 49.7%; P = 0.001 ). Significant differences existed between the serum sodium level and the motor nerve conduction velocity, sensory nerve conduction velocity, part of compound muscle action potential, and sensory nerve action potential of the participants. Compared with hyponatremia, the higher serum sodium level was a relative lower risk factor for DPN after adjusting for several potential confounders ( OR = 0.430 , 95 % CI = 0.220 – 0.841 ; OR = 0.386 , 95 % CI = 0.198 – 0.755 ; OR = 0.297 , 95 % CI = 0.152 – 0.580 ; OR = 0.376 , 95 % CI = 0.190 – 0.743 ; all P < 0.05 ). Compared with low-normal serum sodium groups, the high-normal serum sodium level was also a risk factor for DPN ( OR = 0.690 , 95 % CI = 0.526 – 0.905 , P = 0.007 ). This relationship was particularly apparent in male participants, those aged <65 years, those with a duration of diabetes of <10 years, and those with a urinary albumin − to − creatinine ratio UACR < 30 mg / g . Conclusions. Low serum sodium levels were independently associated with DPN, even within the normal range of the serum sodium. We should pay more attention to avoid the low serum sodium level in patients with type 2 diabetes mellitus.

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The impact of low serum sodium level on mortality depends on glycemic control

European Journal of Clinical Investigation ◽

10.1111/j.1365-2362.2011.02613.x ◽

2011 ◽

Vol 42 (5) ◽

pp. 534-540 ◽

Cited By ~ 9

Author(s):

Osman Z. Sahin ◽

Gulay Asci ◽

Fatih Kircelli ◽

Mumtaz Yilmaz ◽

Soner Duman ◽

...

Keyword(s):

Glycemic Control ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

The Impact ◽

Low Serum

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Adiponectin, markers of subclinical inflammation and nerve conduction in individuals with recently diagnosed type 1 and type 2 diabetes

Acta Endocrinologica ◽

10.1530/eje-15-1010 ◽

2016 ◽

Vol 174 (4) ◽

pp. 433-443 ◽

Cited By ~ 21

Author(s):

Imke Schamarek ◽

Christian Herder ◽

Bettina Nowotny ◽

Maren Carstensen-Kirberg ◽

Klaus Straßburger ◽

...

Keyword(s):

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Nerve Conduction ◽

Sensory Nerve ◽

Intercellular Adhesion Molecule ◽

Subclinical Inflammation ◽

Total Adiponectin ◽

Sum Scores

ObjectiveSubclinical inflammation has been implicated in the development of diabetic sensorimotor polyneuropathy (DSPN), but studies using electrophysiological assessment as outcomes are scarce. Therefore, we aimed to investigate associations of biomarkers reflecting different aspects of subclinical inflammation with motor and sensory nerve conduction velocity (NCV) in individuals with diabetes.Design and methodsMotor and sensory NCV was assessed in individuals with recently diagnosed type 2 (n=352) or type 1 diabetes (n=161) from the baseline cohort of the observational German Diabetes Study. NCV sum scores were calculated for median, ulnar and peroneal motor as well as median, ulnar and sural sensory nerves. Associations between inflammation-related biomarkers, DSPN and NCV sum scores were estimated using multiple regression models.ResultsIn type 2 diabetes, high serum interleukin (IL)-6 was associated with the presence of DSPN and reduced motor NCV. Moreover, higher levels of high-molecular weight (HMW) adiponectin, total adiponectin and their ratio were associated with prevalent DSPN and both diminished motor and sensory NCV, whereas no consistent associations were observed for C-reactive protein, IL18, soluble intercellular adhesion molecule-1 and E-selectin. In type 1 diabetes, only HMW and total adiponectin showed positive associations with motor NCV.ConclusionsOur results point to a link between IL6 and both DSPN and slowed motor NCV in recently diagnosed type 2 diabetes. The reverse associations between adiponectin and NCV in type 1 and type 2 diabetes are intriguing, and further studies should explore whether they may reflect differences in the pathogenesis of DSPN in both diabetes types.

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Impact of Long versus Short Duration Diabetes on Sensory Nerve Conduction Velocity in Type 2 Diabetes Mellitus

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2018/35393.11930 ◽

2018 ◽

Author(s):

Amina Sultan Zaidi ◽

PN Singh ◽

Meenakshi Gupta ◽

Sheelu Shafiq Siddiqi ◽

Abeer Masood

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Conduction Velocity ◽

Short Duration ◽

Nerve Conduction ◽

Nerve Conduction Velocity ◽

Sensory Nerve ◽

Sensory Nerve Conduction Velocity

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Association of Nerve Conduction Velocity with Total Body Fat Mass and Body Mass Index in Type 2 Diabetes Mellitus

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44524.14063 ◽

2020 ◽

Author(s):

Faique Rahman ◽

Anwar Hasan Siddiqui ◽

Sangeeta Singhal ◽

Hamid Ashraf ◽

Ahmad Faraz

Keyword(s):

Type 2 Diabetes ◽

Conduction Velocity ◽

Negative Correlation ◽

Nerve Conduction ◽

Sensory Nerve ◽

Significant Negative Correlation ◽

Posterior Tibial ◽

Total Body Fat ◽

Total Body

Introduction: There is a close association between obesity and type 2 diabetes as well as its complications. Obesity related changes in nerve conduction assume paramount importance in diabetic patients where the nerve functions are already compromised by other metabolic derangements. Aim: To study any existing correlation of the Nerve Conduction Velocity (NCV) with the Total Body Fat Mass (TBFM) and Body Mass Index (BMI) and to identify which is a better predictor of NCV impairment in type 2 diabetics. Materials and Methods: A prospective, cross-sectional study was conducted during April 2018-January 2019 in 90 patients with confirmed diagnosis of Diabetes type 2 of recent onset or not more than 8 years and age between 30 to 60 years. NCV was measured in both upper and lower limbs. Median, ulnar, and posterior tibial nerves were selected for motor nerve conduction study and median, Ulnar and sural nerves were selected for sensory nerve conduction study. Bioelectric Impedance Analysis (BIA) was used to find the TBFM. The correlation of TBFM and BMI with the NCV was assessed by using Pearson’s coefficient of linear correlation. Results: Both BMI and TBFM showed negative correlation with the motor and sensory NCV of both sides of the body. BMI had a significant negative correlation with conduction velocity of two sensory nerve viz., right median (r=-0.388) and left sural (r=-0.356) and two motor nerves viz., right median (r=-0.483) and right posterior tibial (r=-0.305) only. However, the TBFM showed a significant negative correlation with the motor conduction velocity of four motor viz., right median (r=-0.602), right posterior tibial (r=-0.455), left median (r=-0.483) and left posterior tibial (r=-0.288) and four sensory nerves viz., right median (r=-0.411), right sural (r=-0.435), left median (r=-0.461) and left sural (r=-0.408). Conclusion: TBFM as assessed by BIA analysis shows a stronger correlation with the NCV as compared to the BMI and should be used clinically along with electrophysiological studies for the risk factor stratification of diabetic peripheral neuropathy in type 2 diabetes patients.

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