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Low Serum Cholesterol Levels Associated with Increased Nerve Lesions for T2D

September 9, 2019
A common treatment for dyslipidemia, findings could aid in better potential therapies.

A PPM Brief

For dyslipidemia, or an abnormality of lipids in the blood, in patients with type 2 diabetes (T2D), lowering serum cholesterol levels has been seen as a well-established treatment. However, this treatment has been shown to increase nerve lesions (leading to potential neuropathic pain), which suggests that it may be associated with diabetic polyneuropathy (DPN) in patients with T2D. In a recent study, researchers1 from the Heidelberg University Hospital in Germany investigated whether this association between serum cholesterol levels and peripheral nerve lesions in patients with T2D, with and without DPN, was indeed accurate.

A single-center, cross-sectional, prospective cohort study was performed from June 1, 2015 to March 31, 2018. A total of 100 participants with T2D (mean [SD] age, 64.6 [0.9] years; 68 [68.0%] male) participated in the study and consented to undergo magnetic resonance (MR) neurography of the right leg at the hospital’s Department of Neuroradiology. The participants then underwent clinical, serologic, and electrophysiologic assessment at the hospital’s Department of Endocrinology.

Nerve lesions could lead to neuropathic pain in diabetic patients. (Source: 123RF)

Quantification of the nerve’s diameter and lipid equivalent lesion (LEL) load, as well as a subsequent analysis of all acquired clinical and serologic data (with use of 3.0-T MR neurography of the right leg with 3-dimensional reconstruction of the sciatic nerve) was conducted:

  • LEL load correlated positively with the nerve’s mean cross-sectional area (r = 0.44; P < 0.001) and the maximum length of a lesion (r = 0.71; P < 0.001)

The LEL load was negatively associated with:

  • total serum cholesterol level (r = − 0.41; P < 0.001)
  • high-density lipoprotein cholesterol level (r = − 0.30; P = 0.006)
  • low-density lipoprotein cholesterol level (r = − 0.33; P = 0.003)
  • nerve conduction velocities of the tibial (r = − 0.33; P = 0.01) and peroneal (r = − 0.51; P < 0.001) nerves
  • and nerve conduction amplitudes of the tibial (r = − 0.31; P = 0.02) and peroneal (r = − 0.28; P = 0.03) nerves.

The findings suggested that lowering serum cholesterol levels in patients with T2D and DPN may be associated with a higher amount of nerve lesions and declining nerve conduction velocities and amplitudes. Researchers concluded that the results may be beneficial as a platform for emerging therapies that promote an aggressive lowering of serum cholesterol levels in patients with T2D.

Last updated on: September 10, 2019
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