Small fiber neuropathy in obesity

NewsBot · Jun 15, 2006

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Prevalence of somatic small fiber neuropathy in obesity.
Int J Obes (Lond). 2006 Jun 13;

Background:Somatic cutaneous small sensory fiber neuropathy (SSFN) can be an early manifestation of impaired glucose tolerance and diabetes mellitus and/or insulin resistance among obese subjects and is often associated with pain, wound occurrence and impaired wound healing. It is yet unclear as to whether SSFN is prevalent among obese individuals without glucose and/or insulin dysregulation despite abundant evidence of delayed wound healing.

Objective:To observe whether there is hypofunctioning of stimulated capsaicin-sensitive cutaneous nerves (small sensory fibers) in obese subjects with/without hyperglycemia and hyperinsulinemia.

Design, setting and participants:Fifty-eight morbidly obese and 15 lean subjects were recruited for small fiber testing of the forearm in a cross-sectional study. Hyperglycemia was observed in 35 obese subjects. Of 25 obese subjects, hyperinsulinemia was noted in 15, 14 of which were hyperglycemic. No subjects demonstrated symptoms/signs of neuropathy over the hairy skin of the forearm. In fact, a neurological examination revealed that 37 subjects were asymptomatic in the legs and only four complained of a neuropathic pain in the foot. Virtually all subjects were exposed to a set of capsaicin-sensitive tests and measures which were identified by capsaicin desensitization procedures. These tests, conducted while in a supine position in bed at the Banner Good Samaritan Medical Center, Phoenix, examined the two principle roles of cutaneous SSFs, namely conveying pain signals to the CNS and controlling local neurogenic vasodilatation (flare; axon-reflex).

Main outcome measures:Heat-induced pain was assessed by verbal reports of sensation after accommodation and heat-, capsaicin-, and transcutneous stimulation- induced blood flow was measured by laser Doppler flowmetry with probes placed at the site of stimulation and 1 cm remote from the site, the latter to evaluate flare latency and intensity of flare.

Results:Significant depression of pain and flare responses were observed in the obese subjects in all but one test. Decreased pain and flare responses were noted in all subjects without hyperglycemia and hyperinsulinemia. Age negatively correlated with capsaicin-induced flare in both the obese and normal groups.

Conclusion:SSFN was prevalent in the cohort of morbidly obese subjects in a skin area without neurological symptoms or signs and in subjects with/without hyperglycemia and hyperinsulinemia. SSFN may be a serious factor in observations of impaired wound healing among obese subjects, a particularly worrisome problem in an obese aging population given the propensity for small fiber impairment in aging subjects. Small fiber impairment in the younger obese population may signal an early aging phenomenon
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Admin2 · Jun 15, 2006

Obesity

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John Spina · Jun 16, 2006

Small fiber neuropathy has many manifestations(pain,dry skin,engorgement of veins,etc).I was reading about it today.

NewsBot · May 6, 2018

The Relationship between Body Mass Index and Diabetic Foot Ulcer, Sensory, Blood Circulation of Foot on Type II Diabetes Mellitus Patients
Yi Kyu Park, M.D., Jun Young Lee, M.D., Sung Jung, M.D. and Kang Hyeon Ryu, M.D.
J Korean Orthop Assoc. 2018 Apr;53(2):136-142.

Purpose
Excessive weight bearing from obesity may induce pains in the lower extremity and resulting functional abnormality. Here we aimed to identify the relationship, it is intended to identity relationship obesity has with diabetic foot ulcer, sensory function, and blood circulation in diabetic patients.

Materials and Methods
We included patients who hospitalized or visited the department of orthopedic surgery for the treatment of diabetic foot ulcer, between January 2010 and December 2015. Among them, those aged over 30 years, diagnosed with diabetes with a progression of more than one year, and an HbA1c level of less than 7.5% were included for final analysis. For obesity, body mass index (BMI) was used, those with a BMI of over 18.5 kg/m2 were included. Using the Asian cut point of World Health Organization, patients were classified into normal, overweight, or obese. For foot ulcers, patients were classified using the Wagner ulcer classification. For sensory function, it was measured by scoring it with Semmes-Weinstein monofilament of International Working Group on the Diabetic Foot (IWGDF). Moreover for blood circulation, ankle-brachial index (ABI) was measured.

Results
For the sensory function, it was found that the overweight group obtained the highest score and the obesity group obtained the lowest score. For ABI, the overweight group scored the highest and the normal group scored the lowest. Moreover diabetic foot ulcer was the highest in the obesity group and the lowest in the normal group. From these results, it was considered that BMI had no relationship with sensory or blood circulation of the feet. However, the relationship between the diabetic foot ulcer and BMI showed statistical significance; according to the result of regression analysis, BMI of diabetic patients had a positive correlation with diabetic foot ulcer.

Conclusion
This study showed that the sensory function and blood circulation of the feet had no relationship with diabetic foot ulcer; however, BMI appears to have a positive correlation with diabetic foot ulcer. Moreover, it seems to be a good index for determining the risk of diabetic foot ulcer.
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Small fiber neuropathy in obesity

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John Spina Active Member

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Small hole in foot

I don't have a normal toe nail on my smallest toe

Smallish persistent white growth on my sole - not urgent

Small white spots under foot causing piercing pain

Small, but very painful, Plantar Fibroma!

Small black lump on my toe

Strange Small Hole On The Bottom Of My Foot

Share This Page

Small fiber neuropathy in obesity

NewsBot The Admin that posts the news.

Admin2 Administrator Staff Member

John Spina Active Member

NewsBot The Admin that posts the news.

Small hole in foot

I don't have a normal toe nail on my smallest toe

Smallish persistent white growth on my sole - not urgent

Small white spots under foot causing piercing pain

Small, but very painful, Plantar Fibroma!

Small black lump on my toe

Strange Small Hole On The Bottom Of My Foot

Share This Page

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