Total Body Adiposity,Triglycerides, and Leg Fat are Independent Risk Factors for Diabetic Peripheral Neuropathy in Chinese Patients with type 2 Diabetes Mellitus |
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| Institution: | 1. Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China;2. Division of Medical Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing, China;3. Chongqing Center for Disease Control and Prevention, Chongqing, China.;1. University of Texas Southwestern Medical Center, Department of Internal Medicine, Dallas, Texas;2. Providence Thyroid, Endocrinology, and Diabetes Clinic, Waco, Texas (current affiliation);3. Division of Endocrinology, Texas Tech University Health Sciences Center, El Paso, Texas (current affiliation);4. Madison Medical Affiliates, Milwaukee, Wisconsin (current affiliation);5. University of Texas Southwestern Medical Center, Department of Clinical Sciences, Dallas, Texas;6. New York University Medical Center, Department of Internal Medicine, New York, New York, (current affiliation);7. Baylor College of Medicine, Department of Internal Medicine, Houston, Texas (current affiliation).;1. Department of Neurosurgery, Huashan Hospital, Shanghai, China; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115;1. From the Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York. |
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| Abstract: | Objective: To evaluate the risk factors associated with diabetic peripheral neuropathy (DPN) in Chinese patients with type 2 diabetes mellitus (T2DM).Methods: Between January 2014 and December 2017, 107 participants who had obesity with T2DM and 349 participants who had normal weight with T2DM, matched for age, sex, and duration of diabetes, were recruited. The clinical and biochemical parameters were measured in each patient. DPN was diagnosed based on neuropathy symptom score and neuropathy deficit score. Motor and sensory nerve conduction velocities were measured by electromyography. Body fat mass was estimated by dual-energy X-ray absorptiometry, while hepatic steatosis was evaluated by ultrasonography.Results: The group with obesity had a significant higher prevalence of DPN (66.62%) than that (46.99%) of the group with normal weight. Compared to the patients with normal weight, the sural sensory nerve in the right lower limbs of the patients with obesity was more susceptible to damage. Hypertriglyceridemia in the patients with obesity was a significant independent risk factor for DPN (odds ratio [OR], 3.90 [95% confidence interval (CI), 1.01 to 15.02]; P = .04), while the duration of diabetes (OR, 1.33 [95% CI, 1.07 to 1.65]; P<.01) and leg subcutaneous fat mass (OR, 0.72 [95% CI, 0.57 to 0.90]; P<.01) in the patients with normal weight were independent risk factors for DPN. The presence of obesity alone in patients with T2DM could predict high DPN risk (OR, 3.09 [95% CI, 1.11 to 8.65]; P = .04).Conclusion: Reducing total body adiposity and triglyceride levels, as well as avoiding leg subcutaneous fat atrophy, could be new prevention strategies for DPN in Chinese patients with T2DM.Abbreviations: ALB = albumin; ALT = alanine transaminase; AST = aspartate transaminase; AUC = area under the curve; AUCc-p/AUCglu = AUC of C-peptide/AUC of glucose; BMI = body mass index; BP = blood pressure; CI = confidence interval; Cr = creatinine; DBP = diastolic blood pressure; DPN = diabetic peripheral neuropathy; FC-P = fasting C-peptide; FPG = fasting plasma glucose; FFA = free fatty acid; γ-GGT = γ-glutamyl transferase; HbA1c = glycated hemoglobin A1c; HDL-C = high-density-lipoprotein cholesterol; ISI = insulin sensitivity index; ISSI-2 = insulin secretion-sensitivity index-2; LDL-C = low-density-lipoprotein cholesterol; MNCS = motor nerve conduction velocity; OGTT = oral glucose tolerance test; PG = plasma glucose; SAT = subcutaneous adipose tissue; SBP = systolic blood pressure; SNCS = sensory nerve conduction velocity; T2DM = type 2 diabetes mellitus; TC = total cholesterol; TG = triglyceride; UA = uric acid; VAT = visceral adipose tissue; WC = waist circumference |
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