JDB Editor-in-Chief recommends that protein pyrrole adducts are associated with elevated glycemic index and clinical features of diabetic diffuse neuropathy

The new issue of JDB has been launched, including 1 editor-in-chief editorial, 1 review, 5 original articles, this issue of the editor for you to select the editor-in-chief recommended articles, about diabetic neuropathy
.

Nearly 500 million people worldwide have diabetes, and this number is expected to increase by 25% by 2030 and 51% by 2045, when China will have the largest number of diabetics in the world (147 million).

Diabetic diffuse neuropathy is the most common complication of diabetes, affecting the somatic and autonomous components
of the nervous system.
Although the exact cause of this neurological disorder has not been established, elevated blood sugar promotes anaerobic glycolysis; This results in an excessive number of advanced glycation end products, many of which have a pyrrole structure
.
Jianjun Liu from the Shenzhen Center for Disease Control and Prevention in China and Yan Wu from Shenzhen People's Hospital tested the hypothesis
that protein pyrrole adducts are associated with elevated glycemic index and some clinical features in diabetic diffuse neuropathy.
As shown in Figure 1, the researchers surveyed elderly people aged 60-79 who lived in Luohu District, Shenzhen, Guangdong Province, China from 2017 to 2018, excluding patients with abnormal kidney function, aged > 80, and extreme blood glucose levels, and finally included 516 study participants
.
All participants participated in physical examination and epidemiological questionnaires, in which 258 patients with elevated glycemic index (glycosylated hemoglobin HbA1c≥6.
5% and FBG ≥7.
0 mM) were included in the candidate list for distal symmetric multiple neuropathy (DSNP) and resting heart rate assessment
.
Of these 258 people, 156 took a telephone survey on DSNP, 121 participated in a questionnaire, and the resting heart rate assessment excluded 40.

Fasting venous blood and serum were collected with ethylenediaminetetraacetic acid anticoagulant tube, fasting blood glucose level and serum creatinine level were measured, urine samples were collected in the morning of physical examination, and urine ketone bodies, urobilinogen, urine creatinine, urine pyrrole adducts were determined, and the results were adjusted according to the measured urine creatinine to adjust the urinary pyrrole adduct value, and the relevant data were statistically analyzed
using SPSS.

Figure 1 Flow chart of included and excluded study subjects

Of all participants, 52.
1% (n = 269) were female and 47.
8% (n = 247) were male, with the 60-64 year old subgroup (28.
1%), the 65-74 year old subgroup (34.
1%), the 70-74 year old subgroup (27.
1%) of similar size, and the 75-79 age subgroup (10.
7%)
of similar size.
Results showed a strong correlation
between proterole-pyrrole adducts and age-adjusted glycemic index and estimated glomerular filtration rate.
Stratified analysis showed that the median and interquartile values of pyrrole adducts increased with subgroup glucose index, and plasma pyrrole adduct levels increased in participants with DSNP and sinus tachycardia symptoms
.

Figure 2 Stratified analysis of fasting blood glucose (A, C) and glycoate hemoglobin (B, D) at plasma pyrrole adduct (A, B) and adjusted urine pyrrole adduct (C, D) levels

This study provides a new bridge between the somatic and autonomous forms of poor glycemic control and diabetic neuropathy, providing a new link
between blood glucose markers and the etiology of diabetic diffuse neuropathy.
Proteopyrrole adducts in plasma and urine correlate
well with glycemic index (FBG and HbA1c).
In addition, elevated plasma pyrrole adducts are associated with
DSPN positivity and high resting heart rate.

Quote the article

Chen, X, Jiang, Z, Zhang, L, et al.
Protein pyrrole adducts are associated with elevated glucose indices and clinical features of diabetic diffuse neuropathies.
Journal of Diabetes.
2022; 14( 10): 646- 657.
doi:10.
1111/1753-0407.
13318

Journal information

Journal of Diabetes (JDB) is a journal jointly published by Wiley and Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, committed to the research, treatment and education of diabetes, aiming to carry out exchanges and cooperation
between Eastern and Western researchers and practitioners on the epidemiology, etiology, pathogenesis, complications, management and prevention of diabetes, including the molecular, biochemical, physiological and other levels of diabetes.

The journal has been converted to Gold Open Access (OA) in 2022, with a 2021 impact factor of 4.
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Keywords
: diabetes, research, treatment, endocrinology, epidemiology, pathogenesis, prevention