Consistently, a phenotyped cross-sectional study in Mexican adults with type 2 diabetes, including neuropathic subtypes, non-neuropathic diabetics and non-diabetic controls, showed markedly reduced circulating NGF in all diabetic groups versus controls, with no clear separation among neuropathy phenotypes; neuropathic cohorts also exhibited higher ICAM-1/VCAM-1/E-selectin and lower eGFR, linking NGF deficiency with systemic inflammation and endothelial dysfunction [42]. Here, VCAM1 is linked to endothelial dysfunction.