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Elevated von Willebrand factor antigen predicts deterioration in diabetic peripheral nerve function
1Department of Hematology, Royal Hallamshire Hospital, Sheffield, UK.
Diabetologia
|March 1, 1996
Summary
Elevated von Willebrand Factor (vWF), a marker of endothelial damage, is linked to worsening peripheral neuropathy in young diabetic patients, independent of blood sugar control.
Area of Science:
- Endocrinology
- Neurology
- Vascular Biology
Background:
- Diabetes mellitus is associated with microvascular and macrovascular complications.
- Endothelial dysfunction, indicated by plasma von Willebrand Factor (vWF), may play a role in diabetic complications.
- Peripheral neuropathy is a common complication in diabetic patients.
Purpose of the Study:
- To investigate the temporal relationship between plasma vWF and the development of complications in young diabetic patients.
- To determine if vWF levels predict the progression of nerve damage in diabetes.
- To explore the association between endothelial dysfunction and peripheral neuropathy in young individuals with diabetes.
Main Methods:
- Prospective study of 63 young diabetic patients (56 insulin-dependent).
- Assessed plasma vWF antigen and ristocetin co-factor activity at baseline and follow-up.
- Evaluated autonomic function, temperature discrimination, and nerve conduction velocities.
- Compared vWF levels between patients with deteriorating nerve function and those without, controlling for glycaemic control (HbA1).
Main Results:
- Overall, no significant changes in autonomic function or nerve conduction velocities were observed in the entire group.
- Median motor and peroneal latency increased, while motor and sensory potentials decreased significantly at follow-up.
- Patients with significant decreases in nerve conduction velocities had higher baseline and follow-up vWF levels compared to others.
- Elevated vWF predicted deteriorating nerve function independently of glycaemic control or diabetes type.
Conclusions:
- Endothelial dysfunction, as indicated by elevated plasma vWF, may be associated with the development and progression of peripheral neuropathy in young diabetic patients.
- vWF is a potential independent predictor of nerve damage in diabetes.
- Further research is needed to elucidate the mechanisms linking endothelial dysfunction to diabetic neuropathy.