open access

Vol 6, No 5 (2017)
Original articles (submitted)
Published online: 2017-12-28
Get Citation

Beta-endorphin levels in both painful and painless diabetic peripheral neuropathy and its relations to pain characters and severity

Enas T. Elkhamisy, Mayada S. Khalel, Azza A. Elbioumy, Mamdouh R. Elnahas
DOI: 10.5603/DK.2017.0027
·
Clinical Diabetology 2017;6(5):159-171.

open access

Vol 6, No 5 (2017)
Original articles (submitted)
Published online: 2017-12-28

Abstract

Introduction. In the peripheral nervous system (PNS), beta-endorphins produce analgesia by binding to opioid receptors (particularly of the mu subtype) at both preand post-synaptic nerve terminals, primarily exerting their effect through presynaptic binding. Aim was to study serum beta-endorphin levels in diabetic patients with and without diabetic peripheral neuropathy and its relations to characters and severity of pain in patients with painful diabetic peripheral neuropathy. Material and methods. The study was a case control study including 88 participants; 73 diabetics and 15 age and sex matched healthy subjects. For all subjects, levels of HbA1c, serum creatinine, total cholesterol, triglycerides, HDL and LDL as well as serum levels of beta-endorphin were measured. Pain severity was detected by using visual analogue pain scale. Results. Serum beta-endorphin shows no significant difference between diabetic neuropathic, diabetic non neuropathic and control groups (p = 0.275). Serum beta-endorphin shows negative correlation with age (p = 0.049) and HbA1c (p = 0.048). While it was not correlated with pain severity (p = 0.371), NDS: total score (p = 0.803), BMI (p = 0.801), serum creatinine (p = 0.074) or DM duration (p = 0.607). Serum beta-endorphin shows no significant difference between painful and painless neuropathy subgroups (p = 0.701). Conclusion. In our study serum beta-endorphin levels showed no significant difference between patients with painless diabetic peripheral neuropathy and those with painful diabetic peripheral neuropathy with different characters of pain. Also, serum beta-endorphin levels was not correlated with pain severity.

Abstract

Introduction. In the peripheral nervous system (PNS), beta-endorphins produce analgesia by binding to opioid receptors (particularly of the mu subtype) at both preand post-synaptic nerve terminals, primarily exerting their effect through presynaptic binding. Aim was to study serum beta-endorphin levels in diabetic patients with and without diabetic peripheral neuropathy and its relations to characters and severity of pain in patients with painful diabetic peripheral neuropathy. Material and methods. The study was a case control study including 88 participants; 73 diabetics and 15 age and sex matched healthy subjects. For all subjects, levels of HbA1c, serum creatinine, total cholesterol, triglycerides, HDL and LDL as well as serum levels of beta-endorphin were measured. Pain severity was detected by using visual analogue pain scale. Results. Serum beta-endorphin shows no significant difference between diabetic neuropathic, diabetic non neuropathic and control groups (p = 0.275). Serum beta-endorphin shows negative correlation with age (p = 0.049) and HbA1c (p = 0.048). While it was not correlated with pain severity (p = 0.371), NDS: total score (p = 0.803), BMI (p = 0.801), serum creatinine (p = 0.074) or DM duration (p = 0.607). Serum beta-endorphin shows no significant difference between painful and painless neuropathy subgroups (p = 0.701). Conclusion. In our study serum beta-endorphin levels showed no significant difference between patients with painless diabetic peripheral neuropathy and those with painful diabetic peripheral neuropathy with different characters of pain. Also, serum beta-endorphin levels was not correlated with pain severity.
Get Citation

Keywords

endorfin; diabetes; neuropathy

About this article
Title

Beta-endorphin levels in both painful and painless diabetic peripheral neuropathy and its relations to pain characters and severity

Journal

Clinical Diabetology

Issue

Vol 6, No 5 (2017)

Pages

159-171

Published online

2017-12-28

DOI

10.5603/DK.2017.0027

Bibliographic record

Clinical Diabetology 2017;6(5):159-171.

Keywords

endorfin
diabetes
neuropathy

Authors

Enas T. Elkhamisy
Mayada S. Khalel
Azza A. Elbioumy
Mamdouh R. Elnahas

References (43)
  1. Pasnoor M, Dimachkie MM, Kluding P, et al. Diabetic neuropathy part 1: overview and symmetric phenotypes. Neurol Clin. 2013; 31(2): 425–445.
  2. Haanpää ML, Gourlay GK, Kent JL, et al. Treatment considerations for patients with neuropathic pain and other medical comorbidities. Mayo Clin Proc. 2010; 85(3 Suppl): S15–S25.
  3. Selvarajah D, Wilkinson ID, Davies J, et al. Central nervous system involvement in diabetic neuropathy. Curr Diab Rep. 2011; 11(4): 310–322.
  4. Selvarajah D, Wilkinson ID, Emery CJ, et al. Early involvement of the spinal cord in diabetic peripheral neuropathy. Diabetes Care. 2006; 29(12): 2664–2669.
  5. Koob GF. Drugs of abuse: anatomy, pharmacology and function of reward pathways. Trends Pharmacol Sci. 1992; 13(5): 177–184.
  6. Sprouse-Blum AS, Smith G, Sugai D, et al. Understanding endorphins and their importance in pain management. Hawaii Med J. 2010; 69(3): 70–71.
  7. Brunton L. Goodman and Gilman's The Pharmacological Basis of Therapeutics. McGraw-Hill, New York 2006: 547–559.
  8. Miller R. Miller's Anesthesia. 6th ed. Elsevier, Pennsylvania 2005: 382–386.
  9. Bäckryd E, Ghafouri B, Larsson B, et al. Do low levels of beta-endorphin in the cerebrospinal fluid indicate defective top-down inhibition in patients with chronic neuropathic pain? A cross-sectional, comparative study. Pain Med. 2014; 15(1): 111–119.
  10. American Diabetes Association. Standards of Medical Care in Diabetes—2015. Diabetes Care. 2015; 38(1): S1–S93.
  11. Tesfaye S, Chaturvedi N, Eaton SEM, et al. EURODIAB Prospective Complications Study Group. Vascular risk factors and diabetic neuropathy. N Engl J Med. 2005; 352(4): 341–350.
  12. Shaw JE, Zimmet PZ, Gries FA, Ziegler D. Epidemiology of diabetic neuropathy. In: Shaw JE, Zimmet PZ, Gries FA, Ziegler D. ed. Textbook of diabetic neuropathy. Thieme, Stuttgard 2003: 64–82.
  13. Abbott CA, Malik RA, van Ross ERE, et al. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K. Diabetes Care. 2011; 34(10): 2220–2224.
  14. Halawa MR, Karawagh A, Zeidan A, et al. Prevalence of painful diabetic peripheral neuropathy among patients suffering from diabetes mellitus in Saudi Arabia. Curr Med Res Opin. 2010; 26(2): 337–343.
  15. Jambart S, Ammache Z, Haddad F, et al. Prevalence of painful diabetic peripheral neuropathy among patients with diabetes mellitus in the Middle East region. J Int Med Res. 2011; 39(2): 366–377.
  16. Papanas N, Ziegler D. Prediabetic neuropathy: does it exist? Curr Diab Rep. 2012; 12(4): 376–383.
  17. Van Acker K, Bouhassira D, De Bacquer D, et al. Prevalence and impact on quality of life of peripheral neuropathy with or without neuropathic pain in type 1 and type 2 diabetic patients attending hospital outpatients clinics. Diabetes Metab. 2009; 35(3): 206–213.
  18. Ziegler D, Rathmann W, Dickhaus T, et al. KORA Study Group. Neuropathic pain in diabetes, prediabetes and normal glucose tolerance: the MONICA/KORA Augsburg Surveys S2 and S3. Pain Med. 2009; 10(2): 393–400.
  19. Spallone V, Morganti R, D'Amato C, et al. Clinical correlates of painful diabetic neuropathy and relationship of neuropathic pain with sensorimotor and autonomic nerve function. Eur J Pain. 2011; 15(2): 153–160.
  20. Maury E, Brichard SM. Adipokine dysregulation, adipose tissue inflammation and metabolic syndrome. Mol Cell Endocrinol. 2010; 314(1): 1–16.
  21. Spallone V, Morganti R, Greco C, et al. Sensory profiles of neuropathic pain in painful diabetic polyneuropathy. Paper presented at the Diabetologia. SPRINGER. 2011; 54: 460–471.
  22. Baron R, Tölle TR, Gockel U, et al. A cross-sectional cohort survey in 2100 patients with painful diabetic neuropathy and postherpetic neuralgia: Differences in demographic data and sensory symptoms. Pain. 2009; 146(1-2): 34–40.
  23. Veves A, Manes C, Murray HJ, et al. Painful neuropathy and foot ulceration in diabetic patients. Diabetes Care. 1993; 16(8): 1187–1189.
  24. Veves A, Young MJ, Manes C, et al. Differences in Peripheral and Autonomic Nerve Function Measurements in Painful and Painless Neuropathy: A clinical study. Diabetes Care. 1994; 17(10): 1200–1202.
  25. Benbow SJ, Chan AW, Bowsher D, et al. A Prospective Study of Painful Symptoms, Small-fibre Function and Peripheral Vascular Disease in Chronic Painful Diabetic Neuropathy. Diabetic Medicine. 1994; 11(1): 17–21.
  26. Boulton AJM, Malik RA, Arezzo JC, et al. Diabetic somatic neuropathies. Diabetes Care. 2004; 27(6): 1458–1486.
  27. Spallone V, Greco C. Painful and painless diabetic neuropathy: one disease or two? Curr Diab Rep. 2013; 13(4): 533–549.
  28. Kramer HH, Rolke R, Bickel A, et al. Thermal Thresholds Predict Painfulness of Diabetic Neuropathies. Diabetes Care. 2004; 27(10): 2386–2391.
  29. Vrethem M, Boivie J, Arnqvist H, et al. Painful Polyneuropathy in Patients With and Without Diabetes: Clinical, Neurophysiologic, and Quantitative Sensory Characteristics. Clin J Pain. 2002; 18(2): 122–127.
  30. Çakir N, Yetkin I, Karakoç A, et al. l-Carnitine in the treatment of painful diabetic neuropathy and its effect on plasma β-endorphin levels. Current Therapeutic Research. 2000; 61(12): 871–876.
  31. Tsigos C, Gibson S, Crosby SR, et al. Cerebrospinal fluid levels of beta endorphin in painful and painless diabetic polyneuropathy. J Diabetes Complications. 1995; 9(2): 92–96.
  32. Goodwin GM, Austin MP, Curran SM, et al. The elevation of plasma beta-endorphin levels in major depression. J Affect Disord. 1993; 29(4): 281–289.
  33. Freeman R, Raskin P, Hewitt DJ, et al. CAPSS-237 Study Group. Randomized study of tramadol/acetaminophen versus placebo in painful diabetic peripheral neuropathy. Curr Med Res Opin. 2007; 23(1): 147–161.
  34. Veening JG, Gerrits PO, Barendregt HP. Volume transmission of beta-endorphin via the cerebrospinal fluid; a review. Fluids Barriers CNS. 2012; 9(1): 16.
  35. Skipor J, Thiery JC. The choroid plexus œ cerebrospinal fluid system: Undervaluated pathway of neuroendocrine signaling into the brain. Acta Neurobiol Exp. 2008; 68: 414–428.
  36. Foley KM, Kourides IA, Inturrisi CE, et al. beta-Endorphin: analgesic and hormonal effects in humans. Proc Natl Acad Sci U S A. 1979; 76(10): 5377–5381.
  37. Butelman ER, Reed B, Chait BT, et al. Limited effects of beta-endorphin compared to loperamide or fentanyl in a neuroendocrine biomarker assay in non-human primates. Psychoneuroendocrinology. 2008; 33(3): 292–304.
  38. Bruehl S, Chung OkY, Chont M. Chronic pain-related changes in endogenous opioid analgesia: a case report. Pain. 2010; 148(1): 167–171.
  39. Jin HY, Lee KAe, Park TS. The impact of glycemic variability on diabetic peripheral neuropathy. Endocrine. 2016; 53(3): 643–648.
  40. Xu F, Zhao LH, Su JB, et al. The relationship between glycemic variability and diabetic peripheral neuropathy in type 2 diabetes with well-controlled HbA1c. Diabetol Metab Syndr. 2014; 6(1): 139.
  41. Oyibo SO, Prasad Y, Jackson NJ, et al. The relationship between blood glucose excursions and painful diabetic peripheral neuropathy: a pilot study. Diabetic Medicine. 2002; 19(10): 870–873.
  42. Padilla A, Descorbeth M, Almeyda AL, et al. Hyperglycemia magnifies Schwann cell dysfunction and cell death triggered by PA-induced lipotoxicity. Brain Res. 2011; 1370: 64–79.
  43. Kassem HS, Azar ST, Zantout MS, et al. Hypertriglyceridemia and peripheral neuropathy in neurologically asymptomatic patients. Neuro Endocrinol Lett. 2005; 26(6): 775–779.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Czasopismo Diabetologia Kliniczna dostęne jest również w Ikamed - księgarnia medyczna

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl