Discuss The Function Of TNF-α In The Pathogenesis Of Diabetic Symmetric Polyneuropathy

Objective:An association between tumor necrosis factor alpha and diabetic symmetrical polyneuropathy (DSPN)has been described in several studies.The aim of this study was to identify the role of tumor necrosis factor alpha in the pathogenesis of diabetic symmetrical polyneuropathy (DSPN) in patients with known case of type2diabetes(T2DM). This study is also designed to analyze the correlation of TNF-alpha with other clinical data of the patients and to determine other independent risk factors of DSPN besides TNF-alpha.Research design and Methods:A total of four hundred and fifteen subjects with or without T2DM were selected for this study and divided into three groups. Out of the total415subjects, the first group of88non DM subjects were recruited as control from Dagang Oil Hospital. The remaining327T2DM patients (second and third groups) were recruited from the Department of Neuropathy, Metabolic Disease Hospital Tianjin Medical University. T2DM patients were further divided into those with(n=197) and without diabetic symmetrical polyneuropathy (n=130).Tumor necrosis factor alpha (TNF alpha) and other blood parameters were measured in serum sample taken from the T2DM patients. Statistical SPSS17.0was used to conduct statistical analysis, the comparison among normal distribution data was calculated using t test or ANOVA analysis, and rank sum test was used for the skewness distribution data analysis, X2test used for the categorical variables. The Spearman correlation test was used for the relationship analysis. The risk factors for DSPN was analyzed using binary logistic regression.Result:1. There were stastically significant differences in TNF-alpha(P=0.015), BMI (p=0.000),Age(p=0.0000), SBP(p=0.0310), DBP(p=0.000), HbAlc (p=0.000), DM duration (p=0.000) and TG (p=0.000) among the three groups (p<0.05). There were no statistically significant differences in Gender and LDL,HDL,TC among the control, DM and DSPN groups (p>0.05). The LSD post hoc test was used for the comparison of means of subgroups. In comparison to the Control group, higher BMI, TG, HbAlc, and longer duration of DM were statistically significant in the DM group.In the DSPN group higher TNF-alpha, BMI, SBP, Age, TG, HbAlc%and longer duration of disease were seen when compared to the control group. However lower DBP was seen when compared to the control group. When comparing the DSPN and DM groups higher TNF alpha, BMI, DBP and longer duration of disease(DM) were statistically significant in the DSPN group.2. Tumor necrosis factor (TNF-), age of the patient, duration of the disease(T2DM) and Body mass Index (BMI) were found to be the independent risk factors for DSPN.3.There was no significant relationship between TNF-alpha and other variables.Conclusion:1. Tumor Necrosis Factor (TNF-a) has an effect in the pathogenesis of Diabetic symmetric polyneuropathy(DSPN).2. Tumor necrosis factor (TNF-a), age of the patient, duration of the disease (T2DM) and Body mass Index (BMI) were found to be the independent risk factors for DSPN.3. There was no significant correlation between TNF alpha and other variables.