Association between Circulating B-Type Natriuretic Peptide and Diabetic Peripheral Neuropathy: A Cross-Sectional Study of a Chinese Type 2 Diabetic Population

Abstract

Cardiovascular disease which is associated with cardiac dysfunction, usually measured with circulating levels of B-type natriuretic peptide (BNP), has been associated with incidence and progression of diabetic peripheral neuropathy (DPN). The potential relationship of circulating physiological levels of BNP with DPN, however, has not been reported. Circulating levels of BNP were measured in 258 patients with type 2 diabetes mellitus (T2DM), and participants were divided into a DPN group ( n = 61 ) and no DPN group ( n = 197 ). The relationship between circulating physiological levels of BNP and DPN and other parameters was analyzed. Circulating levels of BNP were significantly elevated in T2DM patients with DPN compared to those without ( P = 0.001 ). Circulating levels of BNP were significantly and positively associated with systolic blood pressure ( P = 0.035 ), neutrophil-to-lymphocyte ratio ( P = 0.007 ), creatinine ( P = 0.030 ), vibration perception threshold values ( P = 0.021 ), and the prevalence of diabetic foot ulceration ( P = 0.039 ), peripheral arterial disease ( P = 0.013 ), DPN ( P = 0.032 ), and diabetic nephropathy ( P = 0.020 ) and negatively with lymphocyte count ( P = 0.003 ) and ankle-brachial index ( P = 0.038 ), irrespective of age, sex, and body mass index. Moreover, circulating levels of BNP was an independent decisive factor for the presence of DPN after multivariate adjustment (odds ratio, 1.044; 95% confidence interval, 1.006-1.084; P = 0.024 ). Additionally, the higher quartiles of circulating BNP were related significantly to an increased risk of DPN compared to the lowest quartile ( P = 0.003 ). Last but most importantly, the analysis of receiver operating characteristic curves revealed that the best cutoff value for circulating levels of BNP to predict DPN was 15.18 pg/mL (sensitivity 78.7% and specificity 48.2%). These findings suggest that high circulating physiological levels of BNP may be associated with the development of DPN and may be a potential biomarker for DPN in patients with T2DM.

Serum albumin was negatively associated with diabetic peripheral neuropathy in Chinese population: a cross-sectional study

“…Body mass index (BMI) was calculated by dividing weight in kilograms by height in metres squared. Systolic and diastolic blood pressures were measured in all subjects on the right arm using a standard mercury sphygmomanometer [18]. All measurements were operated by trained study personnel.…”

Curcumin Ameliorates the Experimental Diabetic Peripheral Neuropathy through Promotion of NGF Expression in Rats

“…Diabetic peripheral neuropathy (DPN) is one of the common complications of diabetes. DPN is clinically characterized by peripheral nerve dysfunction accompanied with typical features of numbness and pain [1,2] . The study has shown that in 2017 there are 451 million diabetic patients worldwide, and it was expected to increase up to 693 million by 2045 [3] .…”

“…DPN is clinically characterized by peripheral nerve dysfunction accompanied with typical features of numbness and pain. [1,2] The study has shown that in 2017 there are 451 million diabetic patients worldwide, and it was expected to increase up to 693 million by 2045. [3] Global incidence of DPN among diabetic patients is 9.6 -88.7 % and continues to increase.…”

Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis

“…In total, 60 studies were included in the systematic review,26–85 with 43 of those studies including at least one arterial stiffness measurement suitable for meta-analysis 29–31 33–35 37–39 41 42 46 47 52 53 55 57 59–77 79–85. Although various studies adjusted for age, sex, diabetes duration, or SBP in data analysis, the values used in the meta-analyses were not adjusted for, other than those studies that only included participants of one sex 65 75.…”

“…For the purposes of investigating arterial stiffness and neuropathy, we classified 53 of the studies as cross-sectional,26 28–31 33–36 38–62 64–67 69 71 73–85 5 as case-control37 63 68 70 72 and 2 as cohort 27 32. For cross-sectional studies, all participants had diabetes, except Allison et al 26 and Kuo et al ,46 who included participants regardless of diabetes status, as well as Cho et al ,35 who alongside participants with diabetes, also separately analyzed those with no history of disease known to cause PN.…”