Abstract

Aims/hypothesis We aimed to examine associations of cardiometabolic risk factors, and (pre)diabetes, with (sensorimotor) peripheral nerve function. Methods In 2401 adults (aged 40-75 years) we previously determined fasting glucose, HbA(1c), triacylglycerol, HDL- and LDL-cholesterol, inflammation, waist circumference, blood pressure, smoking, glucose metabolism status (by OGTT) and medication use. Using nerve conduction tests, we measured compound muscle action potential, sensory nerve action potential amplitudes and nerve conduction velocities (NCVs) of the peroneal, tibial and sural nerves. In addition, we measured vibration perception threshold (VPT) of the hallux and assessed neuropathic pain using the DN4 interview. We assessed cross-sectional associations of risk factors with nerve function (using linear regression) and neuropathic pain (using logistic regression). Associations were adjusted for potential confounders and for each other risk factor. Associations from linear regression were presented as standardised regression coefficients (beta) and 95% CIs in order to compare the magnitudes of observed associations between all risk factors and outcomes. Results Hyperglycaemia (fasting glucose or HbA(1c)) was associated with worse sensorimotor nerve function for all six outcome measures, with associations of strongest magnitude for motor peroneal and tibial NCV,beta(fasting glucose) = -0.17 SD (-0.21, -0.13) and beta(fasting glucose) = -0.18 SD (-0.23, -0.14), respectively. Hyperglycaemia was also associated with higher VPT and neuropathic pain. Larger waist circumference was associated with worse sural nerve function and higher VPT. Triacylglycerol, HDL- and LDL-cholesterol, and blood pressure were not associated with worse nerve function; however, antihypertensive medication usage (suggestive of history of exposure to hypertension) was associated with worse peroneal compound muscle action potential amplitude and NCV. Smoking was associated with worse nerve function, higher VPT and higher risk for neuropathic pain. Inflammation was associated with worse nerve function and higher VPT, but only in those with type 2 diabetes. Type 2 diabetes and, to a lesser extent, prediabetes (impaired fasting glucose and/or impaired glucose tolerance) were associated with worse nerve function, higher VPT and neuropathic pain (pfor trend

Original languageEnglish
Pages (from-to)1648-1658
Number of pages11
JournalDiabetologia
Volume63
Issue number8
DOIs
Publication statusPublished - Aug 2020

Keywords

  • Cardiometabolic risk factors
  • Diabetes status
  • Electrophysiological
  • Nerve conduction test
  • Neuropathy
  • The metabolic syndrome
  • AUGSBURG SURVEYS S2
  • METABOLIC SYNDROME
  • SUBCLINICAL INFLAMMATION
  • DIABETIC POLYNEUROPATHY
  • NEUROPATHIC PAIN
  • OBESITY
  • COMPLICATIONS
  • INDIVIDUALS
  • DYSFUNCTION
  • PREVALENCE

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