THE LEVEL OF ERYTHROCYTE ALDOSE REDUCTASE - A RISK FACTOR FOR DIABETIC NEUROPATHY

The level of erythrocyte aldose reductase protein (AR-p) was determine d in diabetic patients as well as in 76 healthy controls by a two-site enzyme-linked immunosorbent assay. No significant difference in the m ean AR-p level was demonstrated between the healthy and diabetic indiv iduals. Based on the results of seven nerve function tests, 95 non-ins ulin-dependent diabetes mellitus (NIDDM) patients were classified into two groups: Group I, without demonstrable neuropathy (less than or eq ual to 1 abnormal test results); Group II, overt neuropathy (greater t han or equal to 2 abnormal results). The AR-p level was significantly higher in Group II than that in Group I. Multivariate logistic regress ion analysis identified two independent risk factors for overt neuropa thy: longer duration of diabetes after clinical diagnosis (odds ratio, 1.15 per year; 95% confidence interval, 1.05-1.25) and a higher level of AR-p (odds ratio, 1.92 per 1 ng mgHb(-1); 95% confidence interval, 1.39-2.65). On 31 patients the AR-p level was re-assessed after a 12- month follow-up period. Irrespective of improved or stable HbA(1c) lev els during the follow-up period, no apparent alteration in the level o f AR-p was demonstrated. These results suggest that erythrocyte AR-p l evel may affect the susceptibility or development of diabetic neuropat hy in NIDDM patients. (C) 1997 Elsevier Science Ireland Ltd.