Association between Caveolin-1 expression and pathophysiological progression of femoral nerves in diabetic foot amputation patients

Abstract Objective To evaluate the pathological changes of femoral nerves and the levels of caveolin-1 in diabetic foot amputation patients with neuropathy, and evaluate the association between caveolin-1 and neuropathy development. Method Thirty seven diabetic foot amputation patients were consecutively recruited from inpatients of Tianjin Metabolic Diseases Hospital between Jan 2003 and Nov 2005. Symptoms and signs of neuropathy, and scores of Toronto Clinical Scoring System (TCSS) were recorded. The nerve conduction velocity and HbA1c were measured. Femoral nerves were obtained 2-3 minutes after amputation. HE, Masson staining and transmission electron microscopy were used for pathological observation. Immunohistochemistry was used to observe changes of axons and count of nerve fiber density (NFD) and detect the levels of caveolin-1. Results HE, Masson and transmission electron microscopy showed nerve fibers were asymmetrical, the degenerated axons part had stronger staining and typical demyelinating changes. Stepwise regression models showed that HbA1c and NFD were the independent factors of caveolin-1 (F=45.090, p<0.001, R2=0.790) expression, and Caveolin-1, diabetes duration were independent factors of NFD (F=27.911, p<0.001, R2=0.691). Conclusion Caveolin-1 may be one of the key factors related to pathophysiological progression of femoral nerves in diabetic foot amputation patients.