Chronic hyperglycemia increases oxidative stress, activates inflammatory pathways and\nreduces nerve growth factor (NGF) among diabetic patients, which contribute to development\nof diabetic peripheral neuropathy (DPN). Tocotrienol-Rich Vitamin E (Tocovid) possesses potent\nantioxidant and anti-inflammatory properties which are postulated to target these pathogeneses in\norder to ameliorate DPN. This study aims to evaluate the effects of Tocovid on nerve conduction\nparameters and serum biomarkers among diabetic patients. This multicenter, prospective,\nrandomized, double-blind, placebo-controlled clinical trial was conducted on 80 eligible participants.\nThe intervention group (n = 39) was randomly allocated to receive 200 mg of Tocovid twice a\nday, and the control group (n = 41) received placebo twice a day. At the end of eight weeks,\nthe nerve conduction parameters, as assessed by nerve conduction study, as well as serum biomarkers\n(NGF, malondialdehyde, vascular cell adhesion molecule 1, tumor necrosis factor receptor 1 and\nthromboxane B2) were compared between the two groups. Compared to placebo, Tocovid significantly\nimproves the nerve conduction velocities of all nerves (+1.25 m/s, interquartile range [IQR] 3.35,\np < 0.001, median nerve; +1.60 m/s, IQR 1.80, p < 0.001, sural nerve; +0.75 m/s, IQR 2.25, p < 0.001,\ntibial nerve). Meanwhile, the levels of serum NGF were significantly higher in the Tocovid group\nas compared to placebo at eight weeks post-intervention. Participants receiving Tocovid illustrated\nhighly significant improvement in terms of nerve conduction velocities for all nerves tested after\neight weeks of supplementation. In addition, Tocovid supplementation elevated the levels of serum\nNGF, in which its increase is postulated to reflect enhanced neuronal functions. This novel finding\nsuggests that Tocovid could be a disease-modifying agent targeting serum NGF to improve nerve\nconduction velocities.
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