oa Molecular Diagnosis and Vaccines - Risk factors for development of peripheral neuropathy in type I diabetes mellitus
This study was done to investigate the role of some risk factors for development of peripheral neuropathy in children and young adolescents with type I diabetes mellitus (type I DM), Diabetic patients were divided into three groups: Group I included 10 diabetic patients with clinically and electrophysiologically evident peripheral neuropathy, Group II included 20 diabetic patients with subclinical peripheral neuropathy evident only by measuring the motor nerve conduction velocity (MNCV) and Group III included 30 diabetic patients without any evidence of peripheral neuropathy. Ten normal healthy individuals with matched age and sex served as a control group (Group IV). All the studied groups were subjected to full clinical and neurological examination, measuring (MNCV) of the common peroneal and median nerves, estimation of glycosylated hemoglobin level (HbA1c), assay of erythrocyte superoxide dismutase (SOD) level as well as molecular genetic study of the manganese superoxide dismutase (Mn-SOD) gene polymorphism. Our results showed that there was a significant increase in HbA1c level and a significant decrease in both erythrocyte SOD level as well as a significant decrease in MNCV of common peroneal and median nerves in group I and group II as compared with group III and group IV. There were significant negative correlations between HbA1c when compared with SOD and MNCV as well as significant positive correlation between SOD levels and MNCV in all the diabetic groups. The frequencies of Ala allele and the Ala/Ala genotype of the Mn-SOD gene were significantly lower in neuropathic diabetic patients.In contrast, the Val allele and Val/Val genotype were significantly more frequent in neuropathic diabetic patients than in diabetic subjects without peripheral neuropathy. This suggests that the Ala(-9)Val dimorphism in the Mn-SOD gene is associated with neuropathy in type 1 diabetes mellitus. In conclusion, Poor glycaemic control, low levels of the key antioxidant enzyme SOD, and the Ala(-9)Val genotype of the Mn-SOD gene were significant risk factors for the development of diabetic neuropathy in type 1 diabetic patients which may necessitate appropriate support for enhancing antioxidant supply to act against the rapid onset and progression of peripheral neuropathy where as the Ala allele and Ala/ Ala genotype are associated with low risk of neuropathy in patients with type 1 DM.
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