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Egyptian Rheumatology and Rehabilitation
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Fas-mediated apoptosis and peripheral polyneuropathy in type 2 diabetes mellitus

Egyptian Rheumatology and Rehabilitation volume 46, pages 321–326 (2019)Cite this article

Abstract

Objective

To evaluate the role of soluble Fas (sFas) and soluble Fas ligand (sFasL) in the pathogenesis of distal symmetrical polyneuropathy (DSPN) in patients with type 2 diabetes mellitus, and to analyze the relationship between these apoptotic markers with clinical parameters and electrophysiologic profile of DSPN, as well as with different diabetic factors among those patients.

Patients and methods

The study included 60 Egyptians with type 2 diabetes mellitus. All patients were evaluated clinically for DSPN by using Michigan Neuropathy Screening Instrument. Electrophysiological diagnosis of DSPN was based on the criteria suggested by the European Standardized Telematic tool to Evaluate Electrodiagnostic Methods group. Diabetic patients were divided into two groups according to the electrophysiological findings: group A included patients with DSPN (N=42), and group B included patients without DSPN (N=18). The severity of DSPN among group A patients was assessed clinically using Toronto Clinical Neuropathy Score and electrophysiologically by the severity score proposed by Hidasi and colleagues. The study also included 30 healthy volunteers as a control group. Serum levels of sFas and sFasL were assessed in all the studied groups.

Results

Serum level of sFas was significantly elevated in diabetic patients with DSPN compared with diabetics without DSPN and nondiabetic control (P=0.029 and 0.000). Receiver operating characteristic (ROC) curve analysis detected that sFas was statistically significant in discriminating between diabetic patients with DSPN from those patients without DSPN with an accuracy of 66%. The cutoff point that has the highest sensitivity (61%) and specificity (62%) was 33.3 ng/ml. Serum level of sFas showed a positive significant correlation with the electrophysiological severity of DSPN (P=0.020). Serum level of sFasL did not show statistically significant difference between all the studied groups.

Conclusion

Fas-mediated apoptosis has an important role in the development of diabetic DSPN and is correlated with its electrophysiological severity.

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Authors and Affiliations

  1. Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Alexandria University, Medaan El-Khartoom Square, Al-Azaritah, Alexandria, 02030, Egypt

    Mowaffak M. Abd Elhameed, Noha A. Elsawy, Sarah S. El-Tawab & Marwa R. Abd Elfadeel Master Degree of Physical Medicine

  2. Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Magdy H. Zekry Mgalaa

  3. Department of Clinical and Chemical Pathology, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Reham A. Abo Elwafa

Authors
  1. Mowaffak M. Abd Elhameed
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  2. Noha A. Elsawy
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  3. Magdy H. Zekry Mgalaa
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  4. Sarah S. El-Tawab
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  5. Reham A. Abo Elwafa
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  6. Marwa R. Abd Elfadeel Master Degree of Physical Medicine
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Correspondence to Marwa R. Abd Elfadeel Master Degree of Physical Medicine.

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Abd Elhameed, M.M., Elsawy, N.A., Mgalaa, M.H.Z. et al. Fas-mediated apoptosis and peripheral polyneuropathy in type 2 diabetes mellitus. Egypt Rheumatol Rehabil 46, 321–326 (2019). https://doi.org/10.4103/err.err_37_19

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  • DOI: https://doi.org/10.4103/err.err_37_19

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