High glucose level as a modifier factor in CMT1A patients. Issue 2 (12th May 2020)

• Record Type: Journal Article
• Authors: Secchin, Juliana B.; Leal, Rita C. C.; Lourenço, Charles M.; Marques, V. D.; Nogueira, Patricia T. L.; Santos, Andre C. J.; Tomaselli, Pedro J.; Marques, Wilson
• Is Part Of: Journal of the peripheral nervous system. Volume 25:Issue 2(2020)
• Page Start: 132
• Page End: 137
• Publication Date: 2020-05-12
• Subjects: Charcot‐Marie‐tooth type 1A -- diabetes mellitus -- impaired glucose tolerance; Nervous system -- Periodicals; Nerves, Peripheral -- Diseases -- Periodicals; Peripheral Nervous System Diseases -- Periodicals; Peripheral Nervous System -- Periodicals; 612.81
• DOI: 10.1111/jns.12379
• Languages: English
• ISSNs: 1085-9489

Abstract

Abstract: Charcot‐Marie‐Tooth disease type 1A (CMT1A) is the most common type of hereditary neuropathy worldwide and diabetes mellitus (DM) is the most frequent cause of peripheral neuropathy in the Western world. CMT1A typically manifest as a predominant motor neuropathy, while, DM‐related neuropathy often manifests as a predominant sensory disorder. There are some evidences that CMT1A patients that also had DM had a more severe neuropathy. Although the real frequency and the underlying mechanisms related to this association has not yet been addressed in the literature. We sought to characterize the phenotypic variability of CMT1A patients with persistent high glucose levels (DM or impaired glucose tolerance [IGT]). Nineteen patients with CMT1A and DM (CMT diab ), seven with CMT1A and IGT (CMT intol ) and 27 with CMT1A without comorbidities were analyzed. They were evaluated through clinical assessment, application of the following scales: visual analogue scale, McGill, CMTNS, SF‐36 and COMPASS 31 and electrophysiological studies. Patients CMT diab had a more severe motor and sensory neuropathy, more intense autonomic symptoms and worse quality of life. Surprisingly, proximal weakness and temporal dispersion on nerve conduction studies are frequently observed in this group. Patients CMT intol also had a more severe neuropathy. Curiously, we observed that the association of CMT1A and glucose metabolism disorders (CMT glic ) clustered in some families. Patients CMT glic develop a more severe neuropathy. As there is yet no cure to CMT1A, a strict blood sugar control may be a useful measure.