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. 2018 Feb 14;5(4):397-405.
doi: 10.1002/acn3.531. eCollection 2018 Apr.

Diabetes and obesity are the main metabolic drivers of peripheral neuropathy

Brian C Callaghan  1 , LeiLi Gao  2 , Yufeng Li  3 , Xianghai Zhou  2 , Evan Reynolds  4 , Mousumi Banerjee  4 , Rodica Pop-Busui  5 , Eva L Feldman  1 , Linong Ji  2
Affiliations

Diabetes and obesity are the main metabolic drivers of peripheral neuropathy

Brian C Callaghan et al. Ann Clin Transl Neurol. .

Abstract

Objective: To determine the associations between individual metabolic syndrome (MetS) components and peripheral neuropathy in a large population-based cohort from Pinggu, China.

Methods: A cross-sectional, randomly selected, population-based survey of participants from Pinggu, China was performed. Metabolic phenotyping and neuropathy outcomes were performed by trained personnel. Glycemic status was defined according to the American Diabetes Association criteria, and the MetS using modified consensus criteria (body mass index instead of waist circumference). The primary peripheral neuropathy outcome was the Michigan Neuropathy Screening Instrument (MNSI) examination. Secondary outcomes were the MNSI questionnaire and monofilament testing. Multivariable models were used to assess for associations between individual MetS components and peripheral neuropathy. Tree-based methods were used to construct a classifier for peripheral neuropathy using demographics and MetS components.

Results: The mean (SD) age of the 4002 participants was 51.6 (11.8) and 51.0% were male; 37.2% of the population had normoglycemia, 44.0% prediabetes, and 18.9% diabetes. The prevalence of peripheral neuropathy increased with worsening glycemic status (3.25% in normoglycemia, 6.29% in prediabetes, and 15.12% in diabetes, P < 0.0001). Diabetes (odds ratio [OR] 2.60, 95% CI 1.77-3.80) and weight (OR 1.09, 95% CI 1.02-1.18) were significantly associated with peripheral neuropathy. Age, diabetes, and weight were the primary splitters in the classification tree for peripheral neuropathy.

Interpretation: Similar to previous studies, diabetes and obesity are the main metabolic drivers of peripheral neuropathy. The consistency of these results reinforces the urgent need for effective interventions that target these metabolic factors to prevent and/or treat peripheral neuropathy.

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Figures

Figure 1
Figure 1
The prevalence of distal symmetric polyneuropathy (DSP) with increasing metabolic syndrome components stratified by glycemic status. DSP was defined as those with a Michigan Neuropathy Screening Instrument (MNSI) Examination score >2. Glycemic status was determined by the glucose tolerance test according to the Expert Committee on the diagnosis and classification of diabetes mellitus. Metabolic syndrome components were defined using modified consensus criteria.
Figure 2
Figure 2
Classification tree analysis for peripheral neuropathy based on demographics and the MetS components. A tree‐based approach was used to build a classifier for peripheral neuropathy based on demographics and metabolic syndrome components. The resulting classification tree allowed identification and characterization of peripheral neuropathy risk groups.
See this image and copyright information in PMC

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