Increased C‐reactive protein is associated with corneal nerve loss and painful neuropathic symptoms in Type 2 diabetes mellitus
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT Aims/Introduction To investigate the association between C‐reactive protein (CRP) with sensory symptoms and deficits and measures of small fiber damage. Materials and Methods Adults with and without T2D underwent corneal confocal microscopy (CCM) and assessment of vibration perception threshold (VPT), DN4 symptom questionnaire, and fasting blood tests for CRP and metabolic markers. Results Of the 122 participants, 77 had T2D of whom 23 (29.9%) had DPN, and 45 were controls. CRP levels were significantly higher in those with T2D without and with DPN compared to controls (5.6 ± 2.9 and 5.4 ± 4.0 vs 3.8 ± 2.9 mg/L, P = 0.008 and P = 0.046, respectively), with no difference between those with and without DPN ( P = 0.894). Higher CRP was independently associated with lower corneal nerve fiber density (CNFD) (β = −5.5 fibers/mm 2 per 10 mg/L increase, P = 0.036), after adjusting for diabetes duration, BMI, HbA1c, and triglycerides. In the DPN group, those with positive symptoms (burning, painful cold, and electric shocks) had higher CRP levels compared to those with negative symptoms (6.5 ± 4.7 vs 3.8 ± 1.9 mg/L, P = 0.039). Conclusions Elevated CRP is associated with small nerve fiber loss and positive neuropathic symptoms in T2D. These findings suggest that CRP may help identify individuals with inflammation‐driven DPN who could benefit from targeted interventions.
DOI: 10.1111/jdi.70246
Authors: Georgios Ponirakis, Ibrahim Al‐Janahi, Einas Elgassim, Ioannis N. Petropoulos, Hoda Gad, Adnan Khan, Hadeel B. Zaghloul, Hamda Ali, Mashhood A. Siddique, Sidra Abdulshakoor, Jenneth M. Concepcion, Sara H. Khalfalla, Iynas S. A. Elamin, Abeer T. H. AlZawqari, Tania Bibi, Marwa A. El Deeb, Lina H. M. Ahmed, Youssra Dakroury, Abeer M. M. El Shewehy, Iuliia Salivon, Mohammad Qasim Minhas, Yara Ismail, Mahmoud A. Zirie, Yousuf Al‐Ansari, Mariam A. O. Al‐Malaheem, Dorothy J. Quadros, Stephen L. Atkin, Rayaz A. Malik
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,850
Funder: Qatar National Research Fund
Awards: G3628015979, G5685639183
OpenAlex ID: W7125482483