{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T09:02:24Z","timestamp":1775638944905,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["UE171\u20103\/1"],"award-info":[{"award-number":["UE171\u20103\/1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["UE171\u201015\/1"],"award-info":[{"award-number":["UE171\u201015\/1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","award":["SNF 310030_215134"],"award-info":[{"award-number":["SNF 310030_215134"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Peripheral Nervous Sys"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Dysfunctional sphingolipid metabolism leads to nerve fiber degeneration, particularly of small caliber A\u03b4 and C fibers, in hereditary sensory and autonomic neuropathies. We aimed to investigate the association of blood 1\u2010deoxysphingolipid (1\u2010deoxySL) profiles and skin denervation in idiopathic small fiber neuropathy (SFN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy\u2010five patients with idiopathic SFN were recruited prospectively. Patients underwent a skin punch biopsy at the lower leg and upper thigh for intraepidermal nerve fiber density (IENFD) quantification. IENFD was correlated with individual blood 1\u2010deoxySL levels, amino acid profiles, and determinants of glucose and lipoprotein metabolism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median distal IENFD in SFN patients was 5.3\u2009fibers\/mm. In 38\/75 (51%) patients, IENFD was \u2264\u20095.3 fibers\/mm (i.e., \u201clow fiber density,\u201d LFD), while in 37\/75 (49%) patients, IENFD was &gt;\u20095.3\u2009fibers\/mm (i.e., \u201chigh fiber density,\u201d HFD). 1\u2010deoxySL was higher in patients with LFD compared to HFD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Fasting plasma glucose was also higher in patients with LFD than in patients with HFD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), while HDL was lower in patients with LFD compared to HFD (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>1\u2010deoxySL, lipoprotein metabolism, and glucose levels are associated with the extent of epidermal denervation in SFN, supporting the role of this metabolic axis in small nerve fiber pathology.<\/jats:p>\n                  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