Evaluation of the Impact of Advanced Glycation End-Products on Peripheral Neuropathy Outcomes in Type 2 Diabetes

Background: Type 2 diabetes mellitus (T2DM) affects over 500 million people worldwide, and over 50% of this group experience the most common complication, diabetic peripheral neuropathy (DPN). The presence of advanced glycation end-products (AGEs) have been linked with the development of DPN. The present study assessed for AGE levels in participants with type 2 diabetes, and explored the hypothesis that there may be increased AGE levels in more severe DPN. Methods: 124 participants with T2DM were consecutively recruited, and underwent skin autofluorescence, clinical assessment for peripheral neuropathy, peripheral nerve ultrasound, nerve conduction studies and axonal excitability assessment. Results: Elevated levels of AGE did not correlate with higher clinical neuropathy scores, sural sensory nerve amplitude, median or tibial nerve cross-sectional area or measures of axonal excitability. While higher AGE readings correlated with diabetic kidney disease, these recordings were not associated with more severe peripheral neuropathy outcomes on multiple regression analysis. Conclusion: The present study suggests that accumulation of AGE is not associated with clinical, electrophysiological and morphological measures of neuropathy in T2DM.