Serum Homocysteine and C-reactive Protein Levels in Diabetic Patients with Nerve Conduction Velocity Proven Neuropathy: A Cross-sectional Study

Abstract

Introduction: Diabetic Neuropathy (DN) is a well known difficult to treat microvascular complication of diabetes. Based on Nerve Conduction Velocity (NCV) studies, DN has been classified into various types. Many possible aetiologies have been proposed. C-Reactive Protein (CRP) plays a role in the development of diabetic microvascular complications, while Homocysteine (Hcys) can harm the endothelium by inducing excessive sulfation of connective tissue. Aim: To study the levels of Hcys and CRP in NCV-proven patients with DN and to associate these levels with the type of DN. Materials and Methods: This was a cross-sectional study conducted at a semi-urban medical college hospital in Western Maharashtra, India, between February 2022 and May 2024. The study included 70 patients over 18 years of age with NCV-proven DN in Type 2 Diabetes Mellitus (DM), in whom serum Hcys and CRP levels were evaluated. Data collected were analysed using Statistical Package for Social Sciences (SPSS) software version 26.0. Results: A total of 32 female participants (45.7%) and 38 male participants (54.3%). Among the study participants, 23 (32.9%) had a duration of diabetes of 5-10 years, and 47 (67.1%) had a mixed type of neuropathy. Elevated Hcys levels were observed in 18 (25.7%) participants, while 49 (70%) showed elevated CRP levels. CRP levels were raised in the mixed type of neuropathy, with 35 (71.4%) affected, while elevated Hcys levels were observed among the sensory neuropathies in 6 (33.3%) participants. Conclusion: No significant association was found between elevated Hcys and CRP levels and the type of neuropathy.

Keywords

• hyperhomocysteinemia
• mixed neuropathy
• neurodegeneration