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Original Article
The Association between Serum GGT Concentration and Diabetic Peripheral Polyneuropathy in Type 2 Diabetic Patients
Ho Chan Cho
Korean Diabetes J. 2010;34(2):111-118.   Published online April 30, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.2.111
  • 4,391 View
  • 39 Download
  • 13 Crossref
AbstractAbstract PDFPubReader   
Background

Diabetic peripheral polyneuropathy (DPP) is one of the common complications of diabetes mellitus (DM) and can lead to foot ulcers or amputation. The pathophysiology of DPP includes several factors such as metabolic, vascular, autoimmune, oxidative stress and neurohormonal growth-factor deficiency and recent studies have suggested the use of serum gamma-glutamyl transferase (GGT) as an early marker of oxidative stress. Therefore, we investigated whether serum GGT may be useful in predicting DPP.

Methods

We assessed 90 patients with type 2 DM who were evaluated for the presence of DPP using clnical neurologic examinations including nerve conduction velocity studies. We evaluated the association between serum GGT and the presence of DPP.

Results

The prevalence of DPP was 40% (36 cases) according to clinical neurological examinations. The serum GGT concentration was significantly elevated in type 2 diabetic patients with DPP compared to patients without DPP (P < 0.01). There were other factors significantly associated with DPP including smoking (P = 0.019), retinopathy (P = 0.014), blood pressure (P < 0.05), aspartate aminotransferase (P = 0.022), C-reactive protein (P = 0.036) and urine microalbumin/creatinine ratio (P = 0.004). Serum GGT was independently related with DPP according to multiple logistic analysis (P < 0.01).

Conclusion

This study shows that increased levels of serum GGT may have important clinical implications in the presence of DPP in patients with type 2 diabetes.

Citations

Citations to this article as recorded by  
  • Validation of the Framingham Diabetes Risk Model Using Community-Based KoGES Data
    Hye Ah Lee, Hyesook Park, Young Sun Hong
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Liver enzymes and risk of ocular motor cranial nerve palsy: a nationwide population-based study
    Joonhyoung Kim, Kyungdo Han, Juhwan Yoo, Kyung-Ah Park, Sei Yeul Oh
    Neurological Sciences.2022; 43(5): 3395.     CrossRef
  • Validity of the diagnosis of diabetic microvascular complications in Korean national health insurance claim data
    Hyung Jun Kim, Moo-Seok Park, Jee-Eun Kim, Tae-Jin Song
    Annals of Clinical Neurophysiology.2022; 24(1): 7.     CrossRef
  • The association of liver enzymes with diabetes mellitus risk in different obesity subgroups: A population-based study
    Dinghao Zheng, Xiaoyun Zhang, Lili You, Feng Li, Diaozhu Lin, Kan Sun, Meng Ren, Li Yan, Wei Wang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Early Biomarkers of Neurodegenerative and Neurovascular Disorders in Diabetes
    Aleksandra Gasecka, Dominika Siwik, Magdalena Gajewska, Miłosz J. Jaguszewski, Tomasz Mazurek, Krzysztof J. Filipiak, Marek Postuła, Ceren Eyileten
    Journal of Clinical Medicine.2020; 9(9): 2807.     CrossRef
  • Dissociable Contributions of Precuneus and Cerebellum to Subjective and Objective Neuropathy in HIV
    Natalie M. Zahr, Kilian M. Pohl, Adolf Pfefferbaum, Edith V. Sullivan
    Journal of Neuroimmune Pharmacology.2019; 14(3): 436.     CrossRef
  • Evaluation of Serum Gamma Glutamyl Transferase Levels in Diabetic Patients With and Without Retinopathy
    Neda Valizadeh, Rasoul Mohammadi, Alireza Mehdizadeh, Qader Motarjemizadeh, Hamid Reza Khalkhali
    Shiraz E-Medical Journal.2018;[Epub]     CrossRef
  • The Effect of Cigarette Smoking on Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis
    Carole Clair, Marya J. Cohen, Florian Eichler, Kevin J. Selby, Nancy A. Rigotti
    Journal of General Internal Medicine.2015; 30(8): 1193.     CrossRef
  • Evaluation of oxidative stress markers and vascular risk factors in patients with diabetic peripheral neuropathy
    Noha Ahmed El Boghdady, Gamal Ali Badr
    Cell Biochemistry and Function.2012; 30(4): 328.     CrossRef
  • Angiotensin-converting enzyme gene single polymorphism as a genetic biomarker of diabetic peripheral neuropathy: longitudinal prospective study
    J. Jurado, J. Ybarra, J.H. Romeo, M. Garcia, E. Zabaleta-del-Olmo
    Journal of Diabetes and its Complications.2012; 26(2): 77.     CrossRef
  • Routine enzymes in the monitoring of type 2 diabetes mellitus
    Osman Evliyaoğlu, Erkan Kibrisli, Yaşar Yildirim, Osman Gökalp, Leyla Çolpan
    Cell Biochemistry and Function.2011; 29(6): 506.     CrossRef
  • Antioxidant Effects of Fermented Red Ginseng Extracts in Streptozotocin-Induced Diabetic Rats
    Hyun-Jeong Kim, Sung-Gyu Lee, In-Gyeong Chae, Mi-Jin Kim, Nam-Kyung Im, Mi-Hee Yu, Eun-Ju Lee, In-Seon Lee
    Journal of Ginseng Research.2011; 35(2): 129.     CrossRef
  • Serum γ‐glutamyltransferase and associated damage among a She Chinese population
    Y. Lin, Y. Xu, G. Chen, B. Huang, J. Yao, Z. Chen, L. Yao, F. Lin, Y. Qiao, Z. Chen, S. Zhu, H. Huang, J. Wen
    Diabetic Medicine.2011; 28(8): 924.     CrossRef
Case Report
A Case of Chronic Inflammatory Demyelinating Polyneuropathy in a Girl with Type 1 DM .
Yi Sun Jang, Hye Soo Kim, Jong Min Lee
Korean Diabetes J. 2006;30(2):130-135.   Published online March 1, 2006
DOI: https://doi.org/10.4093/jkda.2006.30.2.130
  • 1,687 View
  • 19 Download
AbstractAbstract PDF
Chronic inflammatory demyelinating polyneuropathy (CIDP) is an immune-mediated disorder characterized by the symmetrical weakness in both proximal and distal muscles for at least 2 months, hyporeflexia or areflexia, nerve conduction abnormalities, and high CSF protein level. Diabetes mellitus, monoclonal gammopathy, hepatitis C infection, HIV infection, SLE, Sjogren syndrome and lymphoma have been associated with CIDP. The incidence of CIDP in diabetes is not known exactly, but occur more common among diabetic than nondiabetic patients. There is sometimes a difficulty in distinguishing between diabetic polyneuropathy and CIDP, but differential diagnosis is important because CIDP is treatable with immune-modulating therapy. We report a case of CIDP in 22-year-old girl with type 1 DM who presented with generalized motor weakness and walking disturbance which were treated with iv immunoglobulin
Original Articles
Peripheral Polyneruopathy and Hypoinsulinemia in Patients with Type 2 Diabetes.
Y S Jung, K Y Lee, S K Lee, H K Kim, H Y Park, M H Kang
Korean Diabetes J. 2000;24(2):256-266.   Published online January 1, 2001
  • 812 View
  • 16 Download
AbstractAbstract PDF
BACKGROUND
There is little information on the risk factors for diabetic polyneuro-pathy other than glycemic control and duration of diabetes. The relation between diabetic polyneuropathy and hypoinsulinemia is controversial. This study is to determine whether hypoinsulinemia is an additional factor influencing the development of polyneuropathy in patients with type 2 diabetes. METHODS: We performed an oral glucose tolerance test with C-peptide measure-ment in 1'P2 patients with type 2 diabetes. Peripheral polyneuropathy was diagnosed when the patients had both typical symptoms of polyneuropathy and abnormal physical findings or NCV. We analysed the relation between metabolic variables including fasting and postprandial C-peptide levels and diabetic polyneuropathy. RESULTS: In addition to retinopathy and nephropathy, duration of diabetes, low C-peptide level (fasting and postprandial), insulin use, and high HDL-cholesterol level were associated with diabetic polyneuropathy. Multivariate logistic regression model revealed that an independent assoclation of diabetes duration and postprandial 2-hour C-peptide concentration with polyneuropathy. When we stratified the patients into the two groups according to the median duration of diabetes (8 years), the association of low postprandial C-peptide concentration with polyneuro-pathy was significant only in the shorter duration group(< 8 years). However, significant association of HbA(1c) level was shown in the longar duration group. CONCLUSION: Decreased insulin secretory function of the pancreas as well as increased duration of diabetes was indepandently associated with diabetic polyneuropathy in patients with type 2 diabetes. Hypoinsulinemia might be an additional risk factor for the development of diabetic polyneuropathy in type 2 diabetic patients, particularly with short duration, To confirm these relationship further longitudinal study in a large cohort is necessary.
Simple Diagnostic Method of Diabetic Distal Polyneuropathy in Type 2 Diabetics.
Chi Hak Kim, Kyung Il Lee, Sang Gil Han, Jeong Ho Heo, Kwang Jae Lee
Korean Diabetes J. 1998;22(4):561-567.   Published online January 1, 2001
  • 860 View
  • 18 Download
AbstractAbstract PDF
BACKGROUND
Early diagnosis of diabetic distal polyneuropathy, a common chronic complication of diabetes mellitus, is important in the management of diabetes mellitus. Michigan Diabetic Neuropathy Score(MDNS) is a good method for diagnosis of this complication but requires many check lists witb nerve conduction study, which may be troublesome in outpatients. This study was performed to investigate simple and convenient diagnostic means which can be substituted with MDNS. METHODS: 41 patients with type 2 diabetes mellitus were assessed with MDNS which include toe 128 Hz tuning fork test, 10 g filament test, pin wheel test and nerve conduction velocity(NCV). Additionally, l28 Hz tuning fork test, l0 g filament test, pin wheel test on fingers and Tacticon and vibration perception test with Bio-thesiometer on toes and fingers were performed. RESULTS: Toe and finger 128 Hz tuning fork, Tacticon and Bio-thesiometer tests were highly concordant with MDNS(kappa>0.40). Also combined tests such as toe and finger 128Hz tuning fork- Tacticon test and Tacticon-Bio-thesiometer test were highly concordant with MDNS(kappa > 0.40) and more sensitive than single tests. CONCLUSION: The results indicate that finger 128 Hz tuning fork - Tacticon combined test is good, simple and convenient in the diagnosis of diabetic distal polyneurapathy.

Diabetes Metab J : Diabetes & Metabolism Journal