Tulay Yildirim

The association of vitamin D with inflammatory cytokines in diabetic peripheral neuropathy

[Purpose] The effects of vitamin D on the circulating levels of IL-17 and IL-13 were investigated in patients with diabetic peripheral neuropathy, patients with diabetes mellitus type 2 without neuropathy, and healthy controls. [Subjects and Methods] A single-blind controlled clinical study was performed, including70 type 2 diabetic patients with or without diabetic peripheral neuropathy and 33 healthy volunteer controls. The 25(OH)D levels were evaluated using ultra-performance liquid chromatography, and IL-17 and IL-13 levels were assessed using enzyme-linked immunosorbent assays. [Results] The 25(OH) vitamin D concentration was lower in diabetic peripheral neuropathy patients than in diabetes mellitus patients without neuropathy and healthy controls. Similarly, 25(OH)D levels were lower in diabetes mellitus patients than healthy controls. IL-17 and IL-13 levels were higher in diabetes mellitus patients than in controls. Additionally, IL-13 levels were higher in diabetic peripheral neuropathy patients than in diabetes mellitus patients without neuropathy. These differences were statistically significant. There was a significant positive correlation between 25(OH)D and IL-13,and a negative correlation between 25(OH)D andIL-17 in the diabetic and diabetic neuropathy groups. [Conclusion] Vitamin D is a potential modifiable risk factor for diabetic peripheral neuropathy and may regulate inflammatory mediators, e.g., IL-17 and IL-13.

AB0678 A Comparison of Depression and Anxiety Levels in Patients with Non-Radiographic Axial Spondyloarthropathy with Those in Patients with Ankylosing Spondylitis: Table 1.

Background The concept of axial spondyloarthropathy (SpA) recently recommended by the ASAS includes patients comprising the early and late stages of the disease. This concept also includes patients not meeting the criteria for ankylosing spondylitis (AS) but classified as non-radiographic SpA on the basis of chronic lumbar back pain and other characteristics of SpA. Although this group is more heterogeneous and distinct from AS in terms of some characteristics, it still has a similar burden in terms of disease activity. Psychiatric symptoms can often be seen in patients during the course of AS. Depressive symptoms are seen at levels of 27.4–55.5% and anxiety symptoms at levels of 19.5–60.9%. Few studies have investigated this situation in the non-radiographic SpA group. Objectives To assess depression and anxiety levels in AS and non-radiographic SpA groups and to review potentially associated factors. Methods One hundred fifty-five (114 AS, 41 non-radiographic SpA) patients with axial SpA according to the ASAS definition were included in the study. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess activity, visual anolog scale (VAS) for spinal pain, the Bath Ankylosing Spondylitis Functional Index (BASFI) for functional capacity and the Ankylosing Spondylitis Quality of Life (ASQOL) for quality of life. The State-Trait Anxiety inventory (STAI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to determine psychiatric symptoms. Results The AS patient group (mean age 39±10.8, male 73.4%) was older than the non-radiographic SpA group (mean age 35±10.1, male 54.8%), and had a greater preponderance of males. No difference was determined between the two groups in terms of BASDAI, VAS spinal pain, ASQOL or BASFI scores. Psychiatric measurements were also similar between the AS and non-radiographic SpA groups. The STAI, BDI and BAI exhibited good correlated with BASDAI, BASFI, ASQOL and VAS spinal pain (Table).Table 1. Correlations between psychiatric symptoms and disease, functional capacity and quality of life scales BASDAI BASFI VAS spinal pain ASQOL STAI-I (state anxiety) r 0.432 0.343 0.373 0.481 p <0.001 <0.001 <0.001 <0.001 STAI-II (trait anxiety) r 0.375 0.342 0.234 0.420 p <0.001 <0.001 0.005 <0.001 Beck anxiety inventory r 0.430 0.375 0.326 0.508 p <0.001 <0.001 <0.001 <0.001 Beck depression inventory r 0.427 0.432 0.410 0.595 p <0.001 <0.001 <0.001 <0.001 Conclusions Despite the presence of some clinical differences between the AS group and the non-radiographic SpA group, regarded as the early stage of the disease, the two group exhibit similar features in terms of psychiatric symptoms and disease activity. Psychiatric symptoms are closely associated with disease activity, functional capacity and quality of life. Disclosure of Interest None declared