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Diabetes mellitus contributes to carbamazepine resistance in patient with trigeminal neuralgia

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Abstract

Objective

To determine whether diabetes mellitus (DM) contributes to the drug resistance of carbamazepine (CBZ), we investigated the correlation between the blood glucose status and the CBZ resistance condition in patients with trigeminal neuralgia (TN).

Patients and methods

A total of 155 TN patients treated with the CBZ monotherapy were selected at Shanghai General Hospital and Shanghai Xinhua Hospital from September 2018 to January 2020. Among them, 15 were diagnosed with DM. Patients’ CBZ resistance levels were evaluated according to progression-free survival. We utilized ordered multiple classification logistic regression to determine the dominant factors leading to CBZ resistance. We analyzed the correlation between hemoglobin A1c (HbA1c) and progression-free survival using the Pearson correlation analysis.

Results

The regression analysis showed that DM was the only factor affecting CBZ resistance (p = 0.035; OR = 0.327; 95% CI, 0.115–0.926). Progression-free survival was 28.5 ± 21.2 months in the DM group and 66.0 ± 33.2 months in the non-DM group. The concentration of HbA1c in the blood was negatively correlated with progression-free survival (r = − 0.197; p = 0.014).

Conclusions

This study shows that blood glucose status is a significant factor contributing to the CBZ resistance in the treatment of TN. The progression-free survival of patients is affected by the status of DM and blood HbAlc levels.

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Data availability

Data is available upon reasonable request and with permission of Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine.

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Acknowledgments

The authors acknowledge the collaboration of all of the staff and technical member at Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China; and Tongji University, Shanghai, China.

Funding

This research was funded by the National Natural Science Foundation of China (No. 81701359), the Natural Science Foundation of Shanghai (18ZR1430400), and the Cross Research Fund of Medicine and Engineering of Shanghai Jiaotong University (No. YG2016QN32, YG2019QNA67).

Author information

Authors and Affiliations

  1. School of Medicine, Tongji University, Shanghai, China

    Anke Zhang, Ling Yuan, Meiqing Lou & Shaojian Lin

  2. Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Wenbo Zhang, Lingzhao Min & Qiuyang Sun

  3. Department of Neurosurgery, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    Houshi Xu, Yuanzhi Xu, Jie Ren & Meiqing Lou

  4. Pasadena City College, Pasadena, CA, USA

    Chenqi Guo

  5. Department of Acupuncture and Tuina, Dongyang Hospital of Traditional Chinese Medicine, Zhejiang, China

    Lili Wei

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  1. Anke Zhang
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Contributions

Shaojian Lin conceived the original idea and Lili Wei developed the theoretical framework. All authors contributed to the interpretation of the results. All authors discussed the results and contributed to the final version of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Lili Wei or Shaojian Lin.

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The authors declare that they have no competing interests.

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The study was conducted in accordance with local laws. Since it was a retrospective study, there was no need to sign an informed consent.

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Anke Zhang, Wenbo Zhang, and Houshi Xu are co-first authors to the article

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Zhang, A., Zhang, W., Xu, H. et al. Diabetes mellitus contributes to carbamazepine resistance in patient with trigeminal neuralgia. Neurosurg Rev 44, 1119–1125 (2021). https://doi.org/10.1007/s10143-020-01304-4

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  • DOI: https://doi.org/10.1007/s10143-020-01304-4

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