Association between serum neopterin level and diabetic peripheral neuropathy in patients with type 2 diabetes: a pilot observational study.

IF 1.2 Q4 ENDOCRINOLOGY & METABOLISM

Diabetology International Pub Date : 2025-08-24 eCollection Date: 2025-10-01 DOI:10.1007/s13340-025-00847-5

Ayat El-Kholy, Olfat Fawzy, Doaa Sayed, Marwa Abdellah, Emad Gamil Khidr

{"title":"Association between serum neopterin level and diabetic peripheral neuropathy in patients with type 2 diabetes: a pilot observational study.","authors":"Ayat El-Kholy, Olfat Fawzy, Doaa Sayed, Marwa Abdellah, Emad Gamil Khidr","doi":"10.1007/s13340-025-00847-5","DOIUrl":null,"url":null,"abstract":"Background: Diabetic peripheral neuropathy (DPN) is a prevalent and disabling complication of type 2 diabetes mellitus (T2D), leading to significant morbidity and reduced quality of life. Chronic hyperglycemia, metabolic disturbances, and immune system activation are contributors to the development and evolution of DPN. Neopterin, a pteridine derivative produced by activated macrophages, reflects cellular immune activation and oxidative stress, both of which are implicated in diabetic complications. However, the role of serum neopterin as a potential biomarker for diabetic neuropathy has not been fully elucidated. This study aimed to investigate the association between serum neopterin levels and diabetic peripheral neuropathy in patients with T2D.Methods: A total of 90 participants were enrolled, including 60 patients with T2D and 30 age- and sex-matched healthy controls. The T2D group was subdivided into 30 patients with DPN and 30 patients without DPN. Serum neopterin levels were measured using ELISA. All participants underwent nerve conduction studies (NCS) and Toronto clinical neuropathy score (TCNS) assessments. Glycemic and lipid profiles were also analyzed.Results: Serum neopterin levels were significantly elevated in T2D patients with DPN compared to those without neuropathy and healthy controls. Higher neopterin levels were strongly associated with neuropathy severity, as patients with axonal neuropathy exhibited the highest neopterin concentrations. Additionally, neopterin correlated positively with TCNS scores, NCS results, and altered lipid profile, suggesting a link between metabolic dysregulation and immune activation in DPN.Conclusion: Elevated serum neopterin levels may reflect underlying immune activation and oxidative stress in T2D patients with DPN. Neopterin could function as a valuable biomarker for the early detection and severity assessment of DPN.","PeriodicalId":11340,"journal":{"name":"Diabetology International","volume":"16 4","pages":"818-826"},"PeriodicalIF":1.2000,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532523/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetology International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13340-025-00847-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a prevalent and disabling complication of type 2 diabetes mellitus (T2D), leading to significant morbidity and reduced quality of life. Chronic hyperglycemia, metabolic disturbances, and immune system activation are contributors to the development and evolution of DPN. Neopterin, a pteridine derivative produced by activated macrophages, reflects cellular immune activation and oxidative stress, both of which are implicated in diabetic complications. However, the role of serum neopterin as a potential biomarker for diabetic neuropathy has not been fully elucidated. This study aimed to investigate the association between serum neopterin levels and diabetic peripheral neuropathy in patients with T2D.

Methods: A total of 90 participants were enrolled, including 60 patients with T2D and 30 age- and sex-matched healthy controls. The T2D group was subdivided into 30 patients with DPN and 30 patients without DPN. Serum neopterin levels were measured using ELISA. All participants underwent nerve conduction studies (NCS) and Toronto clinical neuropathy score (TCNS) assessments. Glycemic and lipid profiles were also analyzed.

Results: Serum neopterin levels were significantly elevated in T2D patients with DPN compared to those without neuropathy and healthy controls. Higher neopterin levels were strongly associated with neuropathy severity, as patients with axonal neuropathy exhibited the highest neopterin concentrations. Additionally, neopterin correlated positively with TCNS scores, NCS results, and altered lipid profile, suggesting a link between metabolic dysregulation and immune activation in DPN.

Conclusion: Elevated serum neopterin levels may reflect underlying immune activation and oxidative stress in T2D patients with DPN. Neopterin could function as a valuable biomarker for the early detection and severity assessment of DPN.

查看原文本刊更多论文

2型糖尿病患者血清新蝶呤水平与糖尿病周围神经病变的关系：一项初步观察研究

背景：糖尿病周围神经病变（DPN）是2型糖尿病（T2D）的常见致残并发症，导致显著的发病率和生活质量下降。慢性高血糖，代谢紊乱和免疫系统激活是DPN的发展和演变的贡献者。新蝶呤是一种由活化的巨噬细胞产生的蝶呤衍生物，反映细胞免疫激活和氧化应激，这两者都与糖尿病并发症有关。然而，血清新蝶呤作为糖尿病神经病变的潜在生物标志物的作用尚未完全阐明。本研究旨在探讨t2dm患者血清新蝶呤水平与糖尿病周围神经病变的关系。方法：共纳入90名参与者，包括60名T2D患者和30名年龄和性别匹配的健康对照。T2D组再分为有DPN和无DPN的患者各30例。采用ELISA法检测血清新蝶呤水平。所有参与者都进行了神经传导研究（NCS）和多伦多临床神经病变评分（TCNS）评估。还分析了血糖和脂质谱。结果：与无神经病变和健康对照相比，伴有DPN的T2D患者血清新蝶呤水平显著升高。较高的新蝶呤水平与神经病变的严重程度密切相关，因为轴突神经病变患者的新蝶呤浓度最高。此外，新蝶呤与TCNS评分、NCS结果和脂质谱改变呈正相关，表明DPN中代谢失调和免疫激活之间存在联系。结论：T2D合并DPN患者血清新蝶呤水平升高可能反映了潜在的免疫激活和氧化应激。新蝶呤可作为早期发现和评估DPN严重程度的有价值的生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Diabetology International ENDOCRINOLOGY & METABOLISM-

CiteScore

3.90

自引率

4.50%

发文量

期刊介绍： Diabetology International, the official journal of the Japan Diabetes Society, publishes original research articles about experimental research and clinical studies in diabetes and related areas. The journal also presents editorials, reviews, commentaries, reports of expert committees, and case reports on any aspect of diabetes. Diabetology International welcomes submissions from researchers, clinicians, and health professionals throughout the world who are interested in research, treatment, and care of patients with diabetes. All manuscripts are peer-reviewed to assure that high-quality information in the field of diabetes is made available to readers. Manuscripts are reviewed with due respect for the author''s confidentiality. At the same time, reviewers also have rights to confidentiality, which are respected by the editors. The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.