TY - JOUR
T1 - Cardiometabolic risk factors as determinants of peripheral nerve function
T2 - the Maastricht Study
AU - van der Velde, Jeroen H. P. M.
AU - Koster, Annemarie
AU - Strotmeyer, Elsa S.
AU - Mess, Werner H.
AU - Hilkman, Danny
AU - Reulen, Jos P. H.
AU - Stehouwer, Coen D. A.
AU - Henry, Ronald M. A.
AU - Schram, Miranda T.
AU - van der Kallen, Carla J. H.
AU - Schalkwijk, Casper G.
AU - Savelberg, Hans H. C. M.
AU - Schaper, Nicolaas C.
N1 - Funding Information:
This study was supported by the European Regional Development Fund via OP-Zuid, the Province of Limburg, the Dutch Ministry of Economic Affairs (grant 31O.041), Stichting De Weijerhorst (Maastricht, the Netherlands), the Pearl String Initiative Diabetes (Amsterdam, the Netherlands), the Cardiovascular Center (CVC, Maastricht, the Netherlands), CARIM School for Cardiovascular Diseases (Maastricht, the Netherlands), CAPHRI Care and Public Health Research Institute (Maastricht, the Netherlands), NUTRIM School for Nutrition and Translational Research in Metabolism (Maastricht, the Netherlands), Stichting Annadal (Maastricht, the Netherlands) and Health Foundation Limburg (Maastricht, the Netherlands), and by unrestricted grants from Janssen-Cilag B.V. (Tilburg, the Netherlands), Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands) and Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands). The study funders were not involved in the design of the study; the collection, analysis and interpretation of data; writing of the report; or the decision to submit the report for publication. Acknowledgements Authors’ relationships and activities
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/8
Y1 - 2020/8
N2 - 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
AB - 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
KW - Cardiometabolic risk factors
KW - Diabetes status
KW - Electrophysiological
KW - Nerve conduction test
KW - Neuropathy
KW - The metabolic syndrome
KW - AUGSBURG SURVEYS S2
KW - METABOLIC SYNDROME
KW - SUBCLINICAL INFLAMMATION
KW - DIABETIC POLYNEUROPATHY
KW - NEUROPATHIC PAIN
KW - OBESITY
KW - COMPLICATIONS
KW - INDIVIDUALS
KW - DYSFUNCTION
KW - PREVALENCE
U2 - 10.1007/s00125-020-05194-5
DO - 10.1007/s00125-020-05194-5
M3 - Article
C2 - 32537727
SN - 0012-186X
VL - 63
SP - 1648
EP - 1658
JO - Diabetologia
JF - Diabetologia
IS - 8
ER -