STATINS AND DIABETIC NEUROPATHY

• Published in: Clinical neuroradiology (Munich) Vol. 29; no. S1; p. S30
• Main Authors: Jende, Johann, Groner, Jan, Rother, Christian, Kopf, Stefan, Kender, Zoltan, Nawroth, Peter, Heiland, Sabine, Hahn, Arthur, Preisner, Fabian, Hilgenfeld, Tim, Juerchott, Alexander, Bendszus, Ma, Kurz, Felix Tobias
• Format: Journal Article
• Language: English
• Published: Springer 01.09.2019
• Subjects: Analysis; Care and treatment; Diabetes therapy; Diabetic neuropathies; Statins; Type 2 diabetes
• ISSN: 1869-1439; 1869-1447

Background: Lowering serum cholesterol is an established treatment for dyslipidemia in type 2 diabetes (T2D). A recent study found that nerve lesions in T2D increase with low serum cholesterol levels, indicating that lowering serum cholesterol levels may contribute to diabetic neuropathy (DN) in T2D. (1) The objective of this study was to investigate whether there is a correlation between statin doses and peripheral nerve lesions in T2D patients with and without DN. Methods: 100 participants (52 under statin treatment, 48 without stain treatment) underwent magnetic resonance neurography (MRN) of the right leg at 3 Tesla and clinical, serological, and electrophysiological assessment. Three-dimensional reconstruction of the sciatic nerve was performed to quantify the nerve's diameter and lipid equivalent lesion load (LEL) with a subsequent correlation-analysis of all acquired clinical and serological data. Result: LEL correlated negatively with nerve conduction velocities and amplitudes of the tibial (r=-0.33;p = 0.014 and r=-0.31;p = 0.020, respectively) and peroneal nerve (r=-0.51;p < 0.001 and r=-0.28;p = 0.034, respectively). The statin dose, calculated as the equivalent of Simvastatin, correlated positively with the nerve's LEL (r=0.39; p = 0.005) and the nerve's mean cross-sectional area (r = 0.40;p = 0.005). All correlations remained significant after multivariate analysis for patients' sex, age, disease duration, body-mass-index, HbA1c levels, triglycecides, Cystatin C and glomerular filtration rate. Discussion: Our findings indicate that the intake of statins in T2D DN is associated with a higher amount of nerve lesions and nerve swelling. These findings are relevant with regards to emerging therapies that promote an aggressive lowering of serum cholesterol in T2D. Conclusion: Our results indicate that lowering cholesterol with statins is potentially harmful in diabetic neuropathy. Further longitudinal studies on the impact of lipid lowering therapies on the course of DN are required.