Triglycerides Blood Test Could Predict Diabetes Nerve Loss
19 May 2009
A common blood test for triglycerides, a well-known cardiovascular disease risk factor, could also for the first time allow doctors to predict which patients with diabetes are more likely to develop the serious, common complication of neuropathy. Diabetic neuropathy affects around 60 percent of the 23 million people in the United States who have diabetes. It is a complication in both type 1 and type 2 diabetes.
Until now, doctors have lacked an effective way to predict which diabetes patients are at greatest risk of neuropathy. Most often, the condition becomes evident when irreversible nerve damage has already occurred. Neuropathy is the leading cause of diabetes related hospital admissions and amputations that are not secondary to trauma.
Triglycerides are a type of lipid, or fat, that the body makes from calories it doesn't need immediately. Triglycerides are stored in fat cells until they are needed to provide energy. When higher-than-normal amounts circulate in the blood, a person is at higher risk of cardiovascular disease.
Researchers analyzed data from 427 diabetes patients with neuropathy, a condition in which nerves are damaged or lost with resulting numbness, tingling and pain, often in the hands, arms, legs and feet. The data revealed that if a diabetes patient had elevated triglycerides, he or she was significantly more likely to experience worsening neuropathy over a period of one year. Other factors, such as higher levels of other fats in the blood or of blood glucose, did not turn out to be significant.
"In our study, elevated serum triglycerides were the most accurate at predicting nerve fiber loss, compared to all other measures," says Kelli A. Sullivan, co-first author of the study.
"These results set the stage for clinicians to be able to address lowering lipid counts with their diabetes patients with neuropathy as vigilantly as they pursue glucose control," says Eva L. Feldman, senior author of the study.
With a readily available predictor for nerve damage, triglycerides are measured as part of routine blood testing, doctors and patients can take pro-active steps when interventions can do some good, says Feldman.
People can reduce blood triglyceride levels with the same measures that reduce cholesterol levels: by avoiding harmful fats in the diet and exercising regularly.
The new finding adds to an emerging picture of the close connections between cardiovascular disease and diabetes. Elevated triglycerides are one of the most common features of the lipid disorders found in patients with type 2 diabetes, by far the most common form of diabetes, says Rodica Pop-Busui, one of the study's authors.
"Cardiovascular disease is the main cause of excess mortality among patients with diabetes. Research also has shown that the presence of neuropathy is an important predictor of these deaths," says Pop-Busui.
"Our findings in this study reinforce the tight links between cardiovascular disease and peripheral neuropathy in patients with diabetes. We demonstrated that the same lipid particles that contribute to the progression of atherosclerosis are also very important players in peripheral nerve fiber loss."
In addition, the study confirms a growing belief among some diabetes researchers that elevated blood levels of certain lipids, rather than solely elevated blood sugar, are key in the progression of diabetic neuropathy. The study pinpoints triglycerides as the critical indicator.
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References:
1. Wiggin , et al. Elevated Triglycerides Correlate with Progression of Diabetic Neuropathy. Diabetes.2009; 0: db08-1771v1-0.
2. Image by skoriginals
