A cross-sectional study published in JAMA Network Open Journal concludes,
in vivo that low serum cholesterol levels, especially low LDL-C levels, were associated with peripheral nerve swelling and a higher load of LELs. The associated impaired nerve conduction in patients with T2D and DPN may have been attributable to an impairment of nerve regeneration after neuropathic damage. Regarding novel therapies for treating dyslipidemia in patients with T2D, our results suggest that clinical trials of patients with very low serum cholesterol levels should be vigilant about the onset or deterioration of neuropathic symptoms. Additional longitudinal studies on the role of cholesterol metabolism in DPN appear to be required to determine whether there is a critical threshold of serum cholesterol for an impairment of nerve regeneration.
The study may be read at JAMA Open Network. The importance of the study is underpinned by emerging therapies of aggressive cholesterol lowering and suggesting that patients and doctors should pay close attention to signs of neuropathic damage in the case of very low serum cholesterol levels.