Autoimmune markers and neurological complications in non-insulin-dependent diabetes mellitus.
To verify whether autoimmune markers related to nervous system structures and other autoimmunity indexes present in diabetes mellitus are associated with subclinical neuropathy, we examined 48 non-insulin-dependent diabetic patients with and without neuroelectrophysiological alterations. Nerve conduction velocity at the external sciatic-popliteal nerve, at the sural nerve, at the median and ulnar nerves level has been evaluated. Autoimmunity was investigated by evaluating glutamic acid decarboxylase (GAD-Ab), insulin (IAA), GM3, GD3 and GT1b gangliosides, pancreatic islet cell (IC-A) and anti-nervous-tissue autoantibody presence. Nerve conduction velocities were decreased in 72.9% of diabetic patients. Anti-insulin antibodies were detected in seven non-insulin created diabetic patients and in higher amount in subjects with (17.1%) than in those without (7.7%) asymptomatic neuropathy. Anti-GM3 antibodies were detected in four diabetic patients all of whom presented neurological complication. A significant correlation has been found between neurological damage and presence of anti-insulin antibodies (p<0.05). In the case of GM3 autoantibody, a similar result was obtained, but the data failed to reach statistical significance. Our data demonstrate that autoimmunity might play a role in the development of peripheral neuropathy.
Morano
S
S
Department of Clinical Science, Endocrinology, Clinica Medica 2, La Sapienza University, Rome, Italy.
Tiberti
C
C
Cristina
G
G
Sensi
M
M
Cipriani
R
R
Guidobaldi
L
L
Torresi
P
P
Medici
F
F
Anastasi
E
E
Di Mario
U
U
D000368:Aged; D015551:Autoimmunity; D015415:Biomarkers; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000276:immunology*; D003929:Diabetic Neuropathies / Q000276:immunology*; D005260:Female; D005679:G(M3) Ganglioside / Q000276:immunology; D005732:Gangliosides / Q000276:immunology*; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D008297:Male; D008475:Median Nerve / Q000503:physiopathology; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D014459:Ulnar Nerve / Q000503:physiopathology
D015415:Biomarkers; D005679:G(M3) Ganglioside; D005732:Gangliosides; C016481:trisialoganglioside GT1; C026226:ganglioside, GD3; D005968:Glutamate Decarboxylase