The role of insulin resistance in the development of peripheral neuropathy related to chemotherapy

Purpose: Peripheral neuropathy is one of the most common complications of chemotherapy. High blood sugar or insulin resistance is thought to be an important factor in the mechanisms leading to the development of peripheral neuropathy. Method: In this study, we aimed to investigate if insulin resistance has an impact on the progression of chemotherapy induced peripheral neuropathy. The study has been conducted with 73 patients aged between 18-65, who came to oncology outpatient department. They were diagnosed with breast, colon, lung, and ovary cancer and did not have neuropathy before the treatment. The patients, who had spinal or cervical disc herniation or surgery to remove them, a history with chemotherapy, radiotherapy, chronic kidney disease, vitamin B12 deficiency, diabetes mellitus diagnosis, and those who consume alcohol were not included in the study. Insulin resistance; calculated with HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) test. For peripheral neuropathy evaluation, LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) scale and CTCAE (Common Terminology Criteria for Adverse Events) were used. Results: When compared to data from the first stage of the treatment, there was no statistically significant difference between the results of laboratory assessments that had been done in the third and sixth month and in the first year of the treatment (p>0.05). There was a significant positive correlation between peripheral neuropathy, patient evaluations, LANSS score and HOMA-IR levels (r = 0.349, p = 0.07) Conclusion: In our study, positive correlation between HOMA values and LANSS scores at the end of the first year of our patients suggested that there was a relationship between insulin resistance and peripheral neuropathy and that insulin resistance may play a role in the development of peripheral neuropathy due to chemotherapy. Keywords: peripheral neuropathy, BMI, insulin resistance, chemotherapy.