Impact Of Glutathione Peroxidase On Michigan Neuropathy Scale And Nottingham Health Profile In Type 2 Diabetes Mellitus Patients With Neuropathy: A Cross-Sectional Study

Abstract

Background: Diabetic peripheral Neuropathy (DPN) is the most common complication of Type-2 Diabetes Mellitus (T2DM) , affecting almost 50% of all the T2DM patients. DPN has been associated with increase in Disability adjusted life years and decreased Quality of life.

Methods: A cross sectional study was conducted at Hayatabad Medical complex Peshawar, in n=88 T2DM patients from January to August 2023 with ethical approval letter DIR/KMU-ASB&RB/AR/001998. Patients were assessed with Michigan neuropathy scale (history and physical) and Nottingham health profile questionnaire. Glutathione peroxidase (GPX), Malondialdehyde (MDA) levels, Superoxide dismutase (SOD, HbA1c, serum creatinine, and Vitamin B12 levels were recorded from the laboratory records of the patients.

Results: Results reported Significant association of GPX with MDA (P=0.041), and Michigan neuropathy score (P=0.036). Regression model reported significant impact of GPX on Pain (P=0.035, CI 88.11-94.84) and Sleep (P=0.002, CI 0.760-12.698) in patients with T2DM. the combined effect of GPX and SOD and GPX and Vitamin B12 was not significant. MAD concentration in the studied sample was 6.92µM, IQR: 2.745, SOD 94.45 U/mL, IQR: 39.95 and GPX 51.91 U/gHb reported. MDA was elevated in 93%, decreased SOD in 80.6% and decreased GPX was reported in 72.7% of the patients.

Conclusion: the concertation of Antioxidants GPX and SOD was decreased and MDA was elevated in T2DM patients. T2DM patients with lower GPX may report higher score on Michigan neuropathy assessment. Concertation of GPX in Diabetic patients can be found associated with pain and disturbed sleep patterns.