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Akinci G, Savelieff MG, Gallagher G, Callaghan BC, Feldman EL. Diabetic neuropathy in children and youth: New and emerging risk factors. Pediatr Diabetes 2021; 22:132-147. [PMID: 33205601 DOI: 10.1111/pedi.13153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/02/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022] Open
Abstract
Pediatric neuropathy attributed to metabolic dysfunction is a well-known complication in children and youth with type 1 diabetes. Moreover, the rise of obesity and in particular of type 2 diabetes may cause an uptick in pediatric neuropathy incidence. However, despite the anticipated increase in neuropathy incidence, pathogenic insights and strategies to prevent or manage neuropathy in the setting of diabetes and obesity in children and youth remain unknown. Data from adult studies and available youth cohort studies are providing an initial understanding of potential diagnostic, management, and preventative measures in early life. This review discusses the current state of knowledge emanating from these efforts, with particular emphasis on the prevalence, clinical presentation, diagnostic approaches and considerations, and risk factors of neuropathy in type 1 and type 2 diabetes in children and youth. Also highlighted are current management strategies and recommendations for neuropathy in children and youth with diabetes. This knowledge, along with continued and sustained emphasis on identifying and eliminating modifiable risk factors, completing randomized controlled trials to assess effectiveness of strategies like weight loss and exercise, and enhancing awareness to support early detection and prevention, are pertinent to addressing the rising incidence of neuropathy associated with diabetes and obesity in children and youth.
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Affiliation(s)
- Gulcin Akinci
- Department of Neurology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Masha G Savelieff
- Department of Neurology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Gary Gallagher
- Department of Neurology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Brian C Callaghan
- Department of Neurology, University of Michigan Medicine, Ann Arbor, Michigan, USA
| | - Eva L Feldman
- Department of Neurology, University of Michigan Medicine, Ann Arbor, Michigan, USA
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Snahnicanova Z, Mendelova A, Grendar M, Holubekova V, Kostkova M, Pozorciakova K, Jancinová M, Kasubova I, Vojtkova J, Durdik P, Lasabova Z, Ciljakova M, Banovcin P. Association of Polymorphisms in CYBA, SOD1, and CAT Genes with Type 1 Diabetes and Diabetic Peripheral Neuropathy in Children and Adolescents. Genet Test Mol Biomarkers 2018; 22:413-419. [PMID: 29924645 DOI: 10.1089/gtmb.2018.0018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS The aim of our study was to investigate possible associations between three SNPs: rs4673 in the CYBA gene; rs1041740 in the SOD1 gene; and rs1001179 in the CAT gene, and type 1 diabetes (T1D) or diabetic peripheral neuropathy (DPN) in T1D patients. MATERIALS AND METHODS Allelic variants of the selected SNPs were determined by allelic discrimination assays in 114 T1D patients enrolled in the study group and in 90 healthy individuals from a control group. Associations between each of the three SNPs were tested in subgroups of T1D patients divided according to the presence of DPN. RESULTS The TT genotype of rs4673 in the CYBA gene was associated with DPN in T1D patients (OR 4.997, 95% CI 1.403-19.083, p = 0.016). Weak significance was observed for a protective effect of the TT genotype of rs1041740 in the SOD1 gene relative to T1D development (OR 0.318, 95% CI 0.092-0.959, p = 0.056). There was no significant association between the CAT gene SNP rs1001179 and T1D or DPN. CONCLUSION We showed a strong association of the CYBA polymorphism rs4673 with DPN in Slovak children and adolescents with T1D. Further studies are necessary to assess the relationship between rs1041740 and T1D or DPN.
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Affiliation(s)
- Zuzana Snahnicanova
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia .,2 Division of Oncology, Biomedical Center Martin JFM CU, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Andrea Mendelova
- 3 Division of Molecular Medicine, Biomedical Center Martin JFM CU, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Marian Grendar
- 4 Bioinformatic Unit, Biomedical Center Martin JFM CU, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Veronika Holubekova
- 2 Division of Oncology, Biomedical Center Martin JFM CU, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Martina Kostkova
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Katarina Pozorciakova
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Maria Jancinová
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Ivana Kasubova
- 2 Division of Oncology, Biomedical Center Martin JFM CU, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Jarmila Vojtkova
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Peter Durdik
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Zora Lasabova
- 2 Division of Oncology, Biomedical Center Martin JFM CU, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Miriam Ciljakova
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
| | - Peter Banovcin
- 1 Pediatric Department, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava , Martin, Slovakia
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Li X, Lu Y, Wei P. Association between VEGF genetic variants and diabetic foot ulcer in Chinese Han population: A case-control study. Medicine (Baltimore) 2018; 97:e10672. [PMID: 29768333 PMCID: PMC5976339 DOI: 10.1097/md.0000000000010672] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 04/16/2018] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate the association of vascular endothelial growth factor (VEGF) gene polymorphisms with diabetic foot ulcer (DFU) susceptibility in a Chinese Han population.Around 88 type 2 diabetes mellitus (T2DM) patients without DFU and 97 T2DM patients with DFU were enrolled in this study. A total of 103 age and gender matched healthy individuals were recruited as healthy control. VEGF gene polymorphisms rs699947 and rs13207351 were analyzed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method. Odds ratio (OR) with 95% confidence interval (CI) was calculated to assess the association between VEGF gene polymorphisms and DFU risk.The frequency of AA and AC genotypes of rs699947 were lower in DFU patients than that in healthy controls (P = .020, P = .031), suggesting that AC and AA genotypes were negatively associated with DFU risk originating from healthy individuals (OR = 0.496, 95%CI = 0.274-0.899; OR = 0.130, 95%CI = 0.015-1.112). Significantly decreased trend of rs699947 A allele was observed in DFU patients when compared to the controls (P = .004), suggesting A allele was distinctly correlated with decreased DFU risk (OR = 0.490, 95%CI = 0.298-0.804). But no significant differences were detected in rs13207351 genotype and allele distributions between patients and control groups (P > .05).Individuals carrying VEGF rs699947 A allele show low susceptibility to DFU in the Chinese Han population.
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Affiliation(s)
| | - Yonghua Lu
- Department of Hospital Infection Management, Medical College, The First Affiliated Hospital of Shihezi University
| | - Peng Wei
- Department of Hand and Foot Microsurgery Surgery, First Hospital of Ningbo, China
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Prabodha LBL, Sirisena ND, Dissanayake VHW. Susceptible and Prognostic Genetic Factors Associated with Diabetic Peripheral Neuropathy: A Comprehensive Literature Review. Int J Endocrinol 2018; 2018:8641942. [PMID: 29736170 PMCID: PMC5875044 DOI: 10.1155/2018/8641942] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/29/2018] [Indexed: 02/07/2023] Open
Abstract
Type 2 diabetes mellitus (T2D) is a disorder of glucose metabolism. It is a complex process involving the regulation of insulin secretion, insulin sensitivity, gluconeogenesis, and glucose uptake at the cellular level. Diabetic peripheral neuropathy (DPN) is one of the debilitating complications that is present in approximately 50% of diabetic patients. It is the primary cause of diabetes-related hospital admissions and nontraumatic foot amputations. The pathogenesis of diabetic neuropathy is a complex process that involves hyperglycemia-induced oxidative stress and altered polyol metabolism that changes the nerve microvasculature, altered growth factor support, and deregulated lipid metabolism. Recent literature has reported that there are several heterogeneous groups of susceptible genetic loci which clearly contribute to the development of DPN. Several studies have reported that some patients with prediabetes develop neuropathic complications, whereas others demonstrated little evidence of neuropathy even after long-standing diabetes. There is emerging evidence that genetic factors may contribute to the development of DPN. This paper aims to provide an up-to-date review of the susceptible and prognostic genetic factors associated with DPN. An extensive survey of the scientific literature published in PubMed using the search terms "Diabetic peripheral neuropathy/genetics" and "genome-wide association study" was carried out, and the most recent and relevant literature were included in this review.
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Affiliation(s)
- L. B. L. Prabodha
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - N. D. Sirisena
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - V. H. W. Dissanayake
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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