Peripheral Sensory Neuropathy Associates With Micro- or Macroangiopathy

• Published in: Diabetes care Vol. 32; no. 2; pp. 317 - 322
• Main Authors: Kärvestedt, Lars, Mårtensson, Eva, Grill, Valdemar, Elofsson, Stig, von Wendt, Gunvor, Hamsten, Anders, Brismar, Kerstin
• Format: Journal Article
• Language: English
• Published: American Diabetes Association 01.02.2009
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc08-1250

Peripheral Sensory Neuropathy Associates With Micro- or Macroangiopathy Results from a population-based study of type 2 diabetic patients in Sweden Lars Kärvestedt , MD 1 , Eva Mårtensson , MD 2 , Valdemar Grill , MD, PHD 1 3 , Stig Elofsson , PHD 4 , Gunvor von Wendt , PHD 5 , Anders Hamsten , MD, PHD 6 and Kerstin Brismar , MD, PHD 1 1 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden 2 Kronan Primary Health Care Centre, Sundbyberg, Sweden 3 Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, St. Olavs Hospital, Trondheim, Norway 4 Department of Social Work, University of Stockholm, Stockholm, Sweden 5 Department of Vitreoretinal Diseases, St. Eriks Eye Hospital, Stockholm, Sweden 6 Atherosclerosis Research Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden Corresponding author: lars.karvestedt{at}stockholmssjukhem.se Abstract OBJECTIVE —To assess associations between peripheral sensory neuropathy (PSN) and other diabetes-related complications. RESEARCH DESIGN AND METHOD —In an area-based cohort of type 2 diabetic subjects, we investigated 156 subjects (age 61.7 ± 7.2 years and diabetes duration 7.0 ± 5.7 years) by questionnaires, clinical examinations, blood and urine sampling, and review of medical records. RESULTS —Prevalence of PSN, assessed by monofilament and neurothesiometer testing, increased with severity of retinopathy (50% frequency in moderate and 100% in severe or proliferative retinopathy; P = 0.02). Vibration perception threshold was higher in subjects with retinopathy (25.6 ± 8.9 vs. 20.5 ± 8.9 V; P = 0.007). PSN was more common in subjects with overt nephropathy, with higher vibration perception thresholds, than in subjects without overt nephropathy. Subjects with PSN but no retinopathy had twice the prevalence of peripheral vascular disease (PVD) (52%) as subjects with both PSN and retinopathy (19%; P = 0.05). In subjects with PSN alone, PVD was three times more likely (52%) than in subjects without PSN (16%; P = 0.001). In multivariate analysis, PSN was independently associated with PVD (odds ratio 2.31; P = 0.007), age (1.12; P = 0.008), male sex (2.01; P = 0.02), and HDL cholesterol (0.21; P < 0.05) and tended to be independently associated with IGF-1 binding protein (1.03; P = 0.05) but not with diabetes duration or A1C. CONCLUSIONS —In a representative population of type 2 diabetes, PSN is related to microvascular and macrovascular pathology. PSN is possibly affected by the IGF axis. Footnotes Published ahead of print at http://care.diabetesjournals.org on 25 November 2008. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact. Accepted November 7, 2008. Received July 10, 2008. DIABETES CARE