Objectives

We conducted a systematic review of the literature with meta-analysis to determine whether painful diabetic neuropathy is associated with a specific inflammatory profile.

Methods

The study is based on the PRISMA statement for systematic reviews. We performed a search of published studies up until January 2021 in MEDLINE and Web of Science based on heading and free text terms. The search strategy included the phrases: diabetic peripheral neuropathy, painful peripheral neuropathy individually and in combination with the terms: inflammation and inflammatory biomarkers. We screened titles and abstracts and performed data extraction. We also manually searched the article titles in the reference lists of key studies and reviews published in the last 20 years.

Data extraction

Data extracted from the studies included study design, inclusion and exclusion criteria, sample type including serum and plasma, source of the sample including patients with peripheral diabetic neuropathy or patients with painful and painless neuropathy of any etiology. Blood concentrations of all measured cytokines were recorded. Whenever possible we calculated the effect size and confidence interval. Non-human studies were excluded from the meta-analysis.

Results

Thirteen studies were included in this meta-analysis. The study design was cross-sectional, case control or cohort type studies. Specific inflammatory mediators are significantly higher in painful than in painless diabetic neuropathy as well as in painful neuropathies of any etiology. Markers of inflammation are also increased in those patients with diabetes mellitus, who suffer from peripheral neuropathy in comparison to patients with diabetes mellitus but no signs of peripheral neuropathy. A proinflammatory state may be the common denominator of pain and peripheral neuropathy in patients with diabetes mellitus but the inflammatory profiles seem to differ.

中文翻译：

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疼痛性糖尿病神经病变中的全身炎症生物标志物

目标

我们通过荟萃分析对文献进行了系统回顾，以确定疼痛性糖尿病神经病变是否与特定的炎症特征相关。

方法

该研究基于 PRISMA 系统评价声明。我们根据标题和自由文本术语搜索了截至 2021 年 1 月在 MEDLINE 和 Web of Science 中已发表的研究。搜索策略包括以下短语：糖尿病周围神经病变、疼痛性周围神经病变，以及与术语组合：炎症和炎症生物标志物。我们筛选了标题和摘要并进行了数据提取。我们还手动搜索了过去 20 年发表的关键研究和评论的参考列表中的文章标题。

数据提取

从研究中提取的数据包括研究设计、纳入和排除标准、样本类型（包括血清和血浆）、样本来源（包括糖尿病周围神经病变患者或任何病因的疼痛性和无痛性神经病变患者）。记录所有测量的细胞因子的血液浓度。我们尽可能计算效应大小和置信区间。非人类研究被排除在荟萃分析之外。

结果

这项荟萃分析包括 13 项研究。研究设计为横断面、病例对照或队列研究。特定炎症介质在疼痛中显着高于无痛糖尿病神经病变以及任何病因的疼痛神经病变。与患有糖尿病但没有周围神经病变迹象的糖尿病患者相比，患有周围神经病变的糖尿病患者的炎症标志物也有所增加。促炎状态可能是糖尿病患者疼痛和周围神经病变的共同特征，但炎症特征似乎不同。