Inactive Matrix Gla Protein Plasma Levels Are Associated With Peripheral Neuropathy In Type 2 Diabetes

Aims/HypothesisDiabetic peripheral neuropathy is a frequent and severe complication of diabetes. As Matrixgla-protein (MGP) is expressed in several components of the nervous system and is involved in some neurological disease, MGP could play a role in peripheral nervous system homeostasis. The aim of this study was to evaluate factors associated with sensitive diabetic neuropathy in Type 2 Diabetes, and, in particular, dephospho-uncarboxylated MGP (dp-ucMGP), the inactive form of MGP.Methods198 patients with Type 2 Diabetes were included. Presence of sensitive diabetic neuropathy was defined by a neuropathy disability score (NDS) >= 6. Plasma levels of dp-ucMGP were measured by ELISA.ResultsIn this cohort, the mean age was 64+/-8.4 years old, and 80% of patients were men. Peripheral neuropathy was present in 15.7% of the patients and was significantly associated (r = 0.51, p<0.0001) with dp-ucMGP levels (beta = -0.26, p = 0.045) after integrating effects of height (beta = -0.38, p = 0.01), insulin treatment (beta = 0.42, p = 0.002), retinopathy treated by laser (beta = 0.26, p = 0.02), and total cholesterol levels (beta = 0.3, p = 0.03) by multivariable analysis.ConclusionsThe association between diabetic neuropathy and the inactive form of MGP suggests the existence of new pathophysiological pathways to explore. Further studies are needed to determine if dp-ucMGP may be used as a biomarker of sensitive neuropathy. Since dp-ucMGP is a marker of poor vitamin K status, clinical studies are warranted to explore the potential protective effect of high vitamin K intake on diabetic peripheral neuropathy.