Features of clinical and diagnostic parameters of distal symmetrical polyneuropathy in patients with type 2 diabetes mellitus in the dynamics of treatment depending on the endothelial nitric oxide synthase gene G894T polymorphism
Background. The purpose of the study is to determine the dynamics of clinical and laboratory characteristics and functional state of peripheral nerves in patients with type 2 diabetes mellitus (DM) complicated by distal symmetrical polyneuropathy (DSPN) depending on the frequency distribution of the G894T genotypes of endothelial NO-synthase (eNOS) gene polymorphism during the recommended therapy. Materials and methods. 110 patients were examined, they were divided into groups: with initial manifestations of DSPN — 32 (29.1 %), with moderate course — 58 (52.7 %) and with severe course — 20 (18.2 %). Patients received L-arginine preparation during basic treatment. All patients were neurologically examined using Neuropathic Symptomatic Score, Neuropathic Dysfunctional Score, electroneuromyographic testing of the peripheral nerves of the lower extremities; parameters of carbohydrate metabolism, pro- and antioxidant defense, functional state of the endothelium were evaluated. Results. In patients with DSPN and type 2 DM, homozygotes for the minor T allele of the eNOS gene G894T polymorphism, the likelihood of developing severe complications of diabetic polyneuropathy increases: the odds ratio was 2.91 (95 % confidence interval 1.19–7.14; p < 0.05). In patients with GT and GG genotypes, the highest efficacy of the recommended therapy is determined, in contrast to patients with homozygous TT genotype, whose dynamics of clinical, laboratory and functional indicators was significantly lower. Conclusions. Homozygotes for the minor T allele of the eNOS gene G894T polymorphism have an increase in the incidence and the severity of DSPN course on the background of type 2 DM, and also a less stable effect from the treatment of this complication.
Full Text:PDF (Українська)
Alleman CJ, Westerhout KY, Hensen M et аl. Humanistic and economic burden of painful diabetic peripheral neuropathy in Europe: A review of the literature. Diabetes Res Clin Pract. 2015 Aug;109(2):215-25. doi: 10.1016/j.diabres.2015.04.031.
Witzel II, Jelinek HF, Khalaf K, Lee S, Khandoker AH, Alsafar H. Identifying Common Genetic Risk Factors of Diabetic Neuropathies. Front Endocrinol (Lausanne). 2015;6:88. doi: 10.3389/fendo.2015.00088.
Corapcioglu D, Sahin M, Emral R, Celebi ZK, Sener O, Gedik VT. Association of the G894T Polymorphism of the Endothelial Nitric Oxide Synthase Gene with Diabetic Foot Syndrome Foot Ulcer, Diabetic Complications, and Comorbid Vascular Diseases: A Turkish Case-Control Study. Genet Test Mol Biomarkers. 2010 Aug;14(4):483-8. doi: 10.1089/gtmb.2010.0023.
Angeline T, Krithiga HR, Isabel W, Asirvatham AJ, Poornima A. Endothelial Nitric Oxide Synthase Gene Polymorphism (G894T) and Diabetes Mellitus (Type II) among South Indians. Oxidative Medicine and Cellular Longevity. 2011;2011: Article ID 462607. doi: 10.1155/2011/462607.
Butugan MK, Sartor CD, Watari R, Martins MC. Multichannel EMG-base destimation of fiber conduction velocity during isometric contraction of patients with different stages of diabetic neuropathy. J Electromyogr Kinesiol. 2014 Aug;24(4):465-72. doi: 10.1016/j.jelekin.2014.04.007.
Mokrii VYa, Ziablitsev SV, Cryshtal MV. Features of oxidative stress formation in patients with type 2 diabetes mellitus depending on the disease duration and gender. Mìžnarodnij endokrinologìčnij žurnal. 2016;(77):67-71. doi: 10.22141/2224-07126.96.36.1996.78757. (in Ukrainian).
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2018