1. Circulating netrin-1 levels are reduced and related to corneal nerve fiber loss in patients with diabetic neuropathy.
- Author
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Mondal A, Bose C, Pramanik S, Dash D, Mukherjee B, Malik RA, and Mukhopadhyay S
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Biomarkers blood, Case-Control Studies, Microscopy, Confocal, Netrin-1 blood, Diabetic Neuropathies blood, Diabetic Neuropathies pathology, Diabetic Neuropathies etiology, Nerve Fibers pathology, Cornea innervation, Cornea pathology, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 pathology
- Abstract
Aims/introduction: Deficiency of neurotropic factors is implicated in diabetic neuropathy (DN). Netrin-1 is a neurotropic factor, but its association with DN has not been explored. We have assessed the association between serum netrin-1 levels and early diabetic neuropathy assessed by quantifying corneal nerve fiber loss using corneal confocal microscopy., Materials and Methods: A total of 72 participants with type 2 diabetes, without and with corneal nerve fiber loss (DN- n = 42, DN+ n = 30), and 45 healthy controls were studied. Serum netrin-1 levels were measured by enzyme-linked immunosorbent assay, and corneal nerve morphology was assessed using corneal confocal microscopy., Results: Corneal nerve fiber density, branch density, fiber length and serum netrin-1 levels were significantly lower in the DN- and DN+ groups compared with controls (P < 0.001). Netrin-1 levels correlated with corneal nerve fiber length in the DN+ group (r = 0.51; P < 0.01). A receiver operating characteristic curve analysis showed that a netrin-1 cut-off value of 599.6 (pg/mL) had an area under the curve of 0.85, with a sensitivity of 76% and specificity of 74% (P < 0.001; 95% confidence interval 0.76-0.94) for differentiating patients with and without corneal nerve loss., Conclusions: Serum netrin-1 levels show a progressive decline with increasing severity of small nerve fiber damage in patients with diabetes. Netrin-1 could act as a biomarker for small nerve fiber damage in DN., (© 2024 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)
- Published
- 2024
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