CHRISTIAN HERDER, PHD1

OBJECTIVE — Subclinical inflammation represents a risk factor of type 2 diabetes and sev-eral diabetes complications, but data on diabetic neuropathies are scarce. Therefore, we inves-tigated whether circulating concentrations of acute-phase proteins, cytokines, and chemokines differ among diabetic patients with or without diabetic polyneuropathy. RESEARCH DESIGN AND METHODS — We measured 10 markers of subclinical inflammation in 227 type 2 diabetic patients with diabetic polyneuropathy who participated in the population-based MONICA/KORA Survey F3 (2004 –2005; Augsburg, Germany). Diabetic polyneuropathy was diagnosed using the Michigan Neuropathy Screening Instru-ment (MNSI). RESULTS — After adjustment for multiple confounders, high levels of C-reactive protein and interleukin (IL)-6 were most consistently associated with diabetic polyneuropathy, high MNSI score, and specific neuropathic deficits, whereas some inverse associations were seen for IL-18. CONCLUSIONS — This study shows that subclinical inflammation is associated with dia-betic polyneuropathy and neuropathic impairments. This association appears rather specific because only certain immune mediators and impairments are involved. Diabetes Care 32:680–682, 2009 Subclinical inflammation is a risk fac-tor not only for type 2 diabetes (1)but also for diabetes complications such as cardiovascular disease, stroke, di-abetic nephropathy, and diabetic retinop-athy (2 – 4). However, the association between subclinical inflammation and di-abetic polyneuropathy has only been in-vestigated in small studies without definitive results (5,6). Therefore, the aim of this study was to investigate systematically whether pa-tients with type 2 diabetes with or without diabetic polyneuropathy exhibit a differ-ent immune profile and whether associa-tions between subclinical inflammation and diabetic polyneuropathy as well as the individual components of diabetic polyneuropathy are independent of an-thropometric and metabolic factors