Small fiber neuropathy (SFN) is considered the ‘microalbuminuric’ equivalent of diabetic peripheral neuropathy (DPN), and is often overlooked by physicians.

Early detection of SFN is critical for the prevention and treatment of DPN.

Diagnosis of SFN is complicated and time consuming. Up to now, no serum-based indicator that could be used for the specific detection of SFN had been identified.

Phosphorylation of neurofilament heavy chain (pNF-H) is crucial to axonal function and structure, and pNF-H could be released into blood during axonal damage. Axonal damage is considered to be indicative of early-stage SFN.

We hypothesize that pNF-H is closely related to SFN.

Our study selected patients with impaired glucose tolerance (IGT) as research subjects. The neurological complications of such patients have previously received little attention from researchers.

Our study demonstrated the general characteristics, biochemistry, autonomic nerve function, neurophysiology, and thermal thresholds of prediabetic patients with SFN.

Our study revealed a close relationship between pNF-H and SFN.