81-OR: High Throughput Proteomics Identifies Neurofilament Light Chain (NFL) as a Novel Blood Biomarker for Detection of Diabetic Sensorimotor Polyneuropathy

Background: The neurofilament light chain (NFL) is a polypeptide abundant in neuronal axons, reflecting ongoing neuroaxonal degeneration when detected in the blood. However, no previous study has explored NFL as a potential biomarker for diabetic sensorimotor polyneuropathy (DSPN) , a neurodegenerative disease of the peripheral nervous system commonly found in individuals with diabetes. We hypothesized that higher serum NFL levels are associated with DSPN.

Methods: We used data from the German Diabetes Study, a prospective observational study that includes adults with recent-onset diabetes (<1 year) . DSPN was assessed using Toronto consensus criteria. Serum levels of NFL were measured using proximity extension assay, and Poisson regression was used to estimate associations between serum NFL and prevalent DSPN.

Results: From a total of 423 participants, 66 (16%) had DSPN. Serum NFL was inversely correlated with age, eGFR and nerve conduction velocities in motor and sensory nerves (all P_Spearman <0.0001) . After adjustment for age, sex, waist circumference, height, HbA1c, diabetes duration, diabetes type, cholesterol, eGFR, hypertension, cardiovascular diseases, use of lipid-lowering drugs, and NSAIDs, higher serum levels of NFL were associated with prevalent DSPN (RR (95% CI) 1.92 (1.50, 2.45) (P < 0.0001) .

Conclusion: NFL might be useful for detecting DSPN in recent-onset diabetes, but validation in other studies will be required. Considering the absence of FDA-approved biomarkers for DSPN, NFL might be a promising biomarker that could improve the management of DSPN.