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. 2023 Nov 24;42(1):131.
doi: 10.1186/s41043-023-00475-2.

Association between interleg systolic blood pressure difference and apparent peripheral neuropathy in US adults with diabetes: a cross-sectional study

Xipeng Lin  1 , Zhihao Liu  1 , Haoyu Weng  1 , Xu Liu  1 , Shengcong Liu  1 , Jianping Li  2   3
Affiliations

Association between interleg systolic blood pressure difference and apparent peripheral neuropathy in US adults with diabetes: a cross-sectional study

Xipeng Lin et al. J Health Popul Nutr. .

Abstract

Background: Interleg systolic blood pressure difference (ILSBPD) is associated with peripheral artery disease, but the relationship between ILSBPD and apparent peripheral neuropathy in diabetic patients remains unclear. We explored the relationship between ILSBPD and apparent peripheral neuropathy and examined the possible effect modifiers in US adults with diabetes.

Methods: One thousand and fifty-one diabetic participants were included in the study with complete data on systolic blood pressure of the lower extremities and Semmes-Weinstein 10-g monofilament testing from the 1999-2004 National Health and Nutritional Examination Surveys. Systolic blood pressure in the lower extremities was measured using an oscillometric blood pressure device with the patient in the supine position. Apparent peripheral neuropathy was defined as the presence of monofilament insensitivity.

Results: Every 5-mmHg increment in ILSBPD is associated with an about 14% increased risk of apparent peripheral neuropathy in crude model, but after adjustment for covariates, the correlation became nonsignificant (P = 0.160). When participants were divided into groups based on ILSBPD cutoffs of 5, 10 and 15 mmHg in different analyses, there was a significantly increased risk of apparent peripheral neuropathy in the ILSBPD ≥ 15 mmHg group (OR 1.79, 95% CI 1.11-2.91, P = 0.018), even after adjusting for confounders. In subgroup analysis, no interaction effect was found (all P for interaction > 0.05).

Conclusions: In US adults with diabetes, an increase in the ILSBPD (≥ 15 mmHg) was associated with a higher risk of apparent peripheral neuropathy.

Keywords: Age; Apparent peripheral neuropathy; Diabetes; Interleg systolic blood pressure difference; Semmes–Weinstein monofilament test.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study
Fig. 2
Fig. 2
Association between interleg systolic blood pressure difference (ILSBPD) and the risk of apparent peripheral neuropathy. *Adjusted for age, gender, race, brachial systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), total cholesterol (TCHO), high-density lipoprotein-cholesterol (HDL-c), peripheral artery disease status, duration of diabetes, history of hypertension and hypercholesterolemia
Fig. 3
Fig. 3
Forrest plots of the association between ILSBPD ≥ 15 mmHg and apparent peripheral neuropathy in various subgroups. Adjusted, if not stratified, for age, gender, race, brachial systolic blood pressure (SBP), glycosylated hemoglobin (HbA1c), total cholesterol (TCHO), high-density lipoprotein-cholesterol (HDL-c), peripheral artery disease status, duration of diabetes, history of hypertension and hypercholesterolemia. ILSBPD stands for interleg systolic blood pressure difference
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