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Cardiovascular Risk Factors Predict The Development Of Diabetic Peripheral Neuropathy
Author(s) -
Tesfaye S,
Chaturvedi N,
Eaton Sem,
Ward Jd,
Fuller J.
Publication year - 2000
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1046/j.1529-8027.2000.005003175.x
Subject(s) - medicine , diabetes mellitus , prospective cohort study , peripheral neuropathy , risk factor , nephropathy , incidence (geometry) , retinopathy , type 2 diabetes , endocrinology , physics , optics
Hypertension has recently been shown to be an important determinant of diabetic retinopathy and nephropathy. The relationship between cardiovascular risk factors and the incidence of peripheral neuropathy (PN) was examined in type 1 diabetic subjects from 27 centres participating in the EURODIAB Prospective Complications Study. PN was assessed at baseline and follow‐up using a standardised protocol involving combinations of neuropathic symptoms, tendon reflexes, age related vibration perception thresholds and autonomic function tests. Serum lipids/lipoproteins, HbA 1c and albumin excretion rate (AER) were measured in a central laboratory. Of 986 subjects with no PN at baseline (mean age 31 years; mean duration 13 years), 24.6% developed PN over the follow up period (average 7.3 years). The incidence of PN was significantly positively associated with age, duration of diabetes and HbA 1c at baseline. After statistical adjustment for these three factors the following baseline variables were significantly predictive of the development of PN; BMI, AER, triglyceride (p < 0.001), cholesterol and systolic BP (p < 0.01). This prospective study shows that over a 7‐year period, about one quarter of type 1 diabetic patients will develop peripheral neuropathy; age, duration of diabetes and poor glycaemic control being major determinants. The development of PN is also associated with potentially modifiable cardiovascular risk factors such as serum lipids, BP, BMI and AER supporting risk reduction strategies in its prevention. Furthermore, these findings support the role of vascular factors in pathogenesis of PN.