DOI: 10.4103/jod.jod_32_26 ISSN: 2543-3288

Neuron-Specific Enolase and Brain-Derived Neurotrophic Factor as Biomarkers of Neural Injury in Diabetic Neuropathy

Rayam Abd Al Kareem Zaidan, Thana Mohammed Juda
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Abstract

Background:

Diabetic peripheral neuropathy (DPN) is a prevalent and debilitating complication of diabetes mellitus (DM) that is frequently diagnosed at an advanced stage, when substantial nerve damage is irreversible.

Objective:

This study aimed to evaluate the association of serum neuron-specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) levels with the presence and severity of DPN in patients with type 2 DM.

Materials and Methods:

A case–control study was conducted involving 120 participants, comprising 30 patients with diabetes and DPN, 30 patients with diabetes without neuropathy, and 60 healthy controls. Serum concentrations of NSE and BDNF were quantified using an enzyme-linked immunosorbent assay.

Results:

Serum NSE levels were significantly higher in patients with diabetes than in controls ( P < 0.0001), with the highest levels observed in the DPN group. BDNF levels were significantly lower in patients with DM ( P = 0.0002), with the lowest concentrations found in those without neuropathy. Both biomarkers showed good diagnostic performance, with area under the curve values ranging from 0.89 to 0.96. Glycated hemoglobin levels were positively correlated with NSE levels and negatively correlated with BDNF levels. Within the DPN subgroup, lower BDNF levels were associated with severe neuropathy. In the multivariate analysis, lower BDNF levels remained independently associated with greater DPN severity ( P = 0.014), whereas NSE was not significant after adjustment.

Conclusion:

NSE may indicate early neuronal injury, whereas BDNF has a complex, stage-dependent relationship with neuropathy severity. These findings suggest that NSE and BDNF are candidate biomarkers that warrant further investigation in larger prospective studies.

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