Metabolic syndrome and peripheral neuropathy

Muscle Nerve. 2021 Mar;63(3):285-293. doi: 10.1002/mus.27086. Epub 2020 Oct 24.

Abstract

Diabetic peripheral neuropathy and metabolic syndrome (MetS) are both global health challenges with well-established diagnostic criteria and significant impacts on quality of life. Clinical observations, epidemiologic evidence, and animal models of disease have strongly suggested MetS is associated with an elevated risk for cryptogenic sensory peripheral neuropathy (CSPN). MetS neuropathy preferentially affects small unmyelinated axons early in its course, and it may also affect autonomic and large fibers. CSPN risk is linked to MetS and several of its components including obesity, dyslipidemia, and prediabetes. MetS also increases neuropathy risk in patients with established type 1 and type 2 diabetes. In this review we present animal data regarding the role of inflammation and dyslipidemia in MetS neuropathy pathogenesis. Several studies suggest exercise-based lifestyle modification is a promising treatment approach for MetS neuropathy.

Keywords: cryptogenic sensory polyneuropathy, diabetic peripheral neuropathy, dyslipidemia, hypertriglyceridemia, metabolic syndrome, prediabetes, small-fiber neuropathy.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / metabolism
  • Diabetes Mellitus, Type 1 / therapy
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / therapy
  • Diabetic Neuropathies / diagnosis*
  • Diabetic Neuropathies / etiology
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / therapy
  • Diet Therapy
  • Disease Progression
  • Dyslipidemias / epidemiology
  • Dyslipidemias / metabolism
  • Dyslipidemias / therapy
  • Exercise
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Metabolic Syndrome / diagnosis*
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / therapy
  • Obesity / epidemiology
  • Obesity / metabolism
  • Obesity / therapy
  • Peripheral Nervous System Diseases / diagnosis*
  • Peripheral Nervous System Diseases / epidemiology
  • Peripheral Nervous System Diseases / physiopathology
  • Peripheral Nervous System Diseases / therapy
  • Prediabetic State / diagnosis
  • Prediabetic State / epidemiology
  • Prediabetic State / metabolism
  • Risk Factors
  • Small Fiber Neuropathy / diagnosis
  • Small Fiber Neuropathy / epidemiology
  • Small Fiber Neuropathy / physiopathology
  • Small Fiber Neuropathy / therapy
  • Topiramate / therapeutic use

Substances

  • Hypoglycemic Agents
  • Topiramate