Background Early detection of diabetic vascular complications (DVC) is important for better outcomes. The presence of one complication may lead to the elevation of specific biomarkers. This may mask the diagnosis of other complications. The present study aimed at assessment of the role of neuron-specific enolase (NSE) and tumor necrosis factor alpha (TNF-α) in detecting DVC in patients with diabetic peripheral neuropathy (DPN). Methods The study included 80 patients with DPN attending a diabetes outpatient clinic. All participants were subjected to full history taking, physical examination, and laboratory investigations. DPN was diagnosed using the Michigan Neuropathy Score Instrument (MNSI) score. Other complications were diagnosed using standard diagnostic criteria approved by the latest guidelines. Serum levels of NSE and TNF-α were measured. Results NSE was significantly higher in patients with diabetic kidney disease (DKD) compared with those without DKD (P = 0.040). Moreover, NSE was significantly higher in patients with diabetic retinopathy (DR) than patients without DR (P = 0.002). However, there was no significant relation between NSE and peripheral arterial disease (PAD). On the other hand, TNF-α showed no significant difference regarding the three DVC in patients with DPN. A cutoff value of >14.2 μg/l for NSE was able to differentiate significantly patients with DKD from those without DKD while a cutoff value of >16 μg/l for NSE was able to differentiate significantly between patients with DR and patients without DR. Conclusion NSE but not TNF-α could detect DKD and DR in patients with DPN.
Reheem et al. (Tue,) studied this question.