Key result
In patients with type 2 diabetic peripheral neuropathy, combining antihyperglycemic treatment with nutritional neurotherapy significantly reduced serum apelin levels and improved nerve conduction velocity compared to antihyperglycemic treatment alone.
Why the study?
Because apelin is an adipocytokine closely linked to diabetes, this study explored the clinical significance of serum apelin levels in patients with type 2 diabetic peripheral neuropathy before and after treatment.
Does antihyperglycemic treatment combined with nutritional neurotherapy reduce serum apelin levels and improve nerve conduction velocity in patients with type 2 diabetic peripheral neuropathy?
RCT (n=169)
Open-label
Random number table method
No
Does antihyperglycemic treatment combined with nutritional neurotherapy reduce serum apelin levels and improve nerve conduction velocity in patients with type 2 diabetic peripheral neuropathy?
Absolute Event Rate: 376.63% vs 389.18%
p-value: p=<0.05
Serum apelin levels are elevated in diabetic peripheral neuropathy and decrease with effective treatment, suggesting utility as a clinical reference index.
Apelin may track treatment response in diabetic neuropathy; observational data leaves open its value as a clinical biomarker.
BACKGROUND: Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes. As apelin is an adipocytokine closely associated with diabetes, this study explored the clinical significance of serum apelin levels in patients with type 2 DPN before and after treatment. METHODS: In total, 44 patients with T2DM without DPN (non-DPN group), 41 patients with DPN who received antihyperglycemic treatment (DPN-A group), 44 patients with DPN who received antihyperglycemic treatment combined with nutritional neurotherapy (DPN-B group), and 40 healthy control individuals (NC group) were selected continuously enrolled in the present study. Enzyme-linked immunosorbent assays (ELISA) were performed to determine serum levels of apelin and tumor necrosis factor-α (TNF-α). Related apelin, fasting blood glucose (FBG), glycosylated hemoglobin A1c, TNF-α, body mass index, fasting C peptide, and nerve conduction velocity (NCV) were recorded in each group before and after treatment. RESULTS: Serum levels of apelin and TNF-α were higher in patients with diabetes than those in the NC group, as well as in the DPN group as compared to the non-DPN group; furthermore, some NCV values were significantly reduced in the DPN group. After treatment, the serum levels of apelin, TNF-α, and FBG reduced in patients with diabetes; moreover, apelin levels were found significantly lower in the DPN-B group as compared to the DPN-A group, while some NCV values significantly increased in the DPN-B group. Apelin was negatively correlated with part of NCV values and positively correlated with TNF-α and FBG (P < .01). CONCLUSION: Our results show that the increase in serum apelin levels is an important clinical reference index for DPN, while a decrease indicates that the DPN treatment is effective.
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Xu et al. (2021) conducted an RCT in Type 2 diabetic peripheral neuropathy (n=169). Antihyperglycemic treatment combined with nutritional neurotherapy (methylcobalamin and lipoic acid) vs. Antihyperglycemic treatment alone was evaluated on Serum apelin levels (ng/L) after treatment (p=<0.05). In patients with type 2 diabetic peripheral neuropathy, combining antihyperglycemic treatment with nutritional neurotherapy significantly reduced serum apelin levels and improved nerve conduction velocity compared to antihyperglycemic treatment alone.
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