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Differential efficacy of methylcobalamin and alpha-lipoic acid treatment on symptoms of diabetic peripheral neuropathy.
Minerva Endocrinol. 2018 Mar; 43(1):11-18.ME

Abstract

BACKGROUND

Diabetic hyperglycemia damages peripheral nerves by triggering ischemia, oxidative stress, and inflammation. Alpha-lipoic acid (ALA) and methylcobalamin (MC) are known to improve signs of diabetic peripheral neuropathy (DPN), possibly by enhancing neural and vascular endothelial cell metabolism and antioxidant capacity. We evaluated differences in efficacy following short-term MC or ALA treatment on DPN symptoms to guide clinical drug selection.

METHODS

Forty DPN patients were randomly divided into MC and ALA treatment groups (both N.=20) and assessed by the Toronto Clinical Neuropathy Scoring System (TCSS), total symptom score (TSS), visual analog scale (VAS) of positive symptoms, and easy sensory test (EST) for negative symptoms before and after 2 weeks of treatment. Serum malondialdehyde (MDA) and superoxide dismutase (SOD) were also measured.

RESULTS

Neuropathy as measured by TCSS, TSS, and VAS scores was significantly reduced by both treatments (P<0.05) but magnitude varied by symptom. The VAS score reductions for burning and pain were significantly greater following ALA (P<0.01), while MC reduced numbness and paresthesia VAS scores to a slightly greater extent than ALA (P>0.05). Numbers of abnormal (low-response) points for pressure and pinprick sensation were reduced by MC but not by ALA, while both treatments induced a significant reduction in vibratory perception threshold (P<0.01). Neither MC nor ALA improved temperature sensation or tendon reflexes (P>0.05). Alpha-lipoic acid, increased SOD and reduced MDA (P<0.05), indicating enhanced antioxidant capacity, while MC had no effect.

CONCLUSIONS

Due to differences in efficacy, MC or ALA should be chosen according to the symptoms of individual patients.

Authors+Show Affiliations

Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.Department of Endocrinology and Tuberculosis, Guangzhou Chest Hospital, Guangzhou, China.Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.Department of Thoracic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China.Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.Department of Clinical Laboratory, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.Department of Clinical Laboratory, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.Department of Thoracic Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China - hanyajuannanfang@163.com.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27901334

Citation

Han, Yajuan, et al. "Differential Efficacy of Methylcobalamin and Alpha-lipoic Acid Treatment On Symptoms of Diabetic Peripheral Neuropathy." Minerva Endocrinologica, vol. 43, no. 1, 2018, pp. 11-18.
Han Y, Wang M, Shen J, et al. Differential efficacy of methylcobalamin and alpha-lipoic acid treatment on symptoms of diabetic peripheral neuropathy. Minerva Endocrinol. 2018;43(1):11-18.
Han, Y., Wang, M., Shen, J., Zhang, Z., Zhao, M., Huang, J., Chen, Y., Chen, Z., Hu, Y., & Wang, Y. (2018). Differential efficacy of methylcobalamin and alpha-lipoic acid treatment on symptoms of diabetic peripheral neuropathy. Minerva Endocrinologica, 43(1), 11-18. https://doi.org/10.23736/S0391-1977.16.02505-0
Han Y, et al. Differential Efficacy of Methylcobalamin and Alpha-lipoic Acid Treatment On Symptoms of Diabetic Peripheral Neuropathy. Minerva Endocrinol. 2018;43(1):11-18. PubMed PMID: 27901334.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential efficacy of methylcobalamin and alpha-lipoic acid treatment on symptoms of diabetic peripheral neuropathy. AU - Han,Yajuan, AU - Wang,Min, AU - Shen,Jie, AU - Zhang,Zhen, AU - Zhao,Min, AU - Huang,Jing, AU - Chen,Youming, AU - Chen,Zhi, AU - Hu,Yulan, AU - Wang,Yubing, Y1 - 2016/11/30/ PY - 2016/12/3/pubmed PY - 2018/8/22/medline PY - 2016/12/1/entrez SP - 11 EP - 18 JF - Minerva endocrinologica JO - Minerva Endocrinol. VL - 43 IS - 1 N2 - BACKGROUND: Diabetic hyperglycemia damages peripheral nerves by triggering ischemia, oxidative stress, and inflammation. Alpha-lipoic acid (ALA) and methylcobalamin (MC) are known to improve signs of diabetic peripheral neuropathy (DPN), possibly by enhancing neural and vascular endothelial cell metabolism and antioxidant capacity. We evaluated differences in efficacy following short-term MC or ALA treatment on DPN symptoms to guide clinical drug selection. METHODS: Forty DPN patients were randomly divided into MC and ALA treatment groups (both N.=20) and assessed by the Toronto Clinical Neuropathy Scoring System (TCSS), total symptom score (TSS), visual analog scale (VAS) of positive symptoms, and easy sensory test (EST) for negative symptoms before and after 2 weeks of treatment. Serum malondialdehyde (MDA) and superoxide dismutase (SOD) were also measured. RESULTS: Neuropathy as measured by TCSS, TSS, and VAS scores was significantly reduced by both treatments (P<0.05) but magnitude varied by symptom. The VAS score reductions for burning and pain were significantly greater following ALA (P<0.01), while MC reduced numbness and paresthesia VAS scores to a slightly greater extent than ALA (P>0.05). Numbers of abnormal (low-response) points for pressure and pinprick sensation were reduced by MC but not by ALA, while both treatments induced a significant reduction in vibratory perception threshold (P<0.01). Neither MC nor ALA improved temperature sensation or tendon reflexes (P>0.05). Alpha-lipoic acid, increased SOD and reduced MDA (P<0.05), indicating enhanced antioxidant capacity, while MC had no effect. CONCLUSIONS: Due to differences in efficacy, MC or ALA should be chosen according to the symptoms of individual patients. SN - 1827-1634 UR - https://www.unboundmedicine.com/medline/citation/27901334/Differential_efficacy_of_methylcobalamin_and_alpha_lipoic_acid_treatment_on_symptoms_of_diabetic_peripheral_neuropathy_ L2 - https://www.minervamedica.it/index2.t?show=R07Y2018N01A0011 DB - PRIME DP - Unbound Medicine ER -