title: Morphometric analysis of connective tissue sheaths of sural nerve in diabetic and nondiabetic patients.
abstract: One of the most common complications of diabetes mellitus is diabetic neuropathy. It may be provoked by metabolic and/or vascular factors, and depending on duration of disease, various layers of nerve may be affected. Our aim was to investigate influence of diabetes on the epineurial, perineurial, and endoneurial connective tissue sheaths. The study included 15 samples of sural nerve divided into three groups: diabetic group, peripheral vascular disease group, and control group. After morphological analysis, morphometric parameters were determined for each case using ImageJ software. Compared to the control group, the diabetic cases had significantly higher perineurial index (P < 0.05) and endoneurial connective tissue percentage (P < 0.01). The diabetic group showed significantly higher epineurial area (P < 0.01), as well as percentage of endoneurial connective tissue (P < 0.01), in relation to the peripheral vascular disease group. It is obvious that hyperglycemia and ischemia present in diabetes lead to substantial changes in connective tissue sheaths of nerve, particularly in peri- and endoneurium. Perineurial thickening and significant endoneurial fibrosis may impair the balance of endoneurial homeostasis and regenerative ability of the nerve fibers. Future investigations should focus on studying the components of extracellular matrix of connective tissue sheaths in diabetic nerves.
authors.affiliation: Department of Anatomy, Faculty of Medicine, University of Niš, Boulevard Dr. Zoran Đinđić 81, 18000 Niš, Serbia.
authors.forename: Braca
authors.initials: B
authors.lastname: Kundalić
authors.affiliation: Department of Anatomy, Faculty of Medicine, University of Niš, Boulevard Dr. Zoran Đinđić 81, 18000 Niš, Serbia.
authors.forename: Slađana
authors.initials: S
authors.lastname: Ugrenović
authors.affiliation: Department of Anatomy, Faculty of Medicine, University of Niš, Boulevard Dr. Zoran Đinđić 81, 18000 Niš, Serbia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Jovanović
authors.affiliation: Chair of Medical Subjects, Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva Street 10A, 18000 Niš, Serbia.
authors.forename: Natalija
authors.initials: N
authors.lastname: Stefanović
authors.affiliation: Department of Histology and Embryology, Faculty of Medicine, University of Niš, Boulevard Dr. Zoran Đinđić 81, 18000 Niš, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Petrović
authors.affiliation: Faculty of Medicine, University of Niš, Boulevard Dr. Zoran Đinđić 81, 18000 Niš, Serbia.
authors.forename: Jasen
authors.initials: J
authors.lastname: Kundalić
authors.affiliation: Department of Anatomy, Faculty of Medicine, University of Niš, Boulevard Dr. Zoran Đinđić 81, 18000 Niš, Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Stojanović
authors.affiliation: Department of Anatomy, Faculty of Medicine, University of Niš, Boulevard Dr. Zoran Đinđić 81, 18000 Niš, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Živković
authors.affiliation: Chair of Medical Subjects, Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva Street 10A, 18000 Niš, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Antić
mesh_terms: D000368:Aged; D003238:Connective Tissue / Q000294:innervation* / Q000503:physiopathology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology; D010525:Peripheral Nerves / Q000503:physiopathology; D013497:Sural Nerve / Q000503:physiopathology*