Correlation Between Different Stages of Diabetic Nephropathy and Neuropathy in Patients with T2DM: A Cross-Sectional Controlled Study

Abstract

IntroductionEarly detection of diabetic peripheral neuropathy (DPN) is critical in patients with type 2 diabetes mellitus (T2DM) due to the lack of targeted therapy for DPN. We have investigated the relationship between different stages of diabetic nephropathy and DPN in an attempt to elucidate whether albuminuria can be used as an early warning signal of DPN progression.MethodsA total of 217 T2DM patients who met the inclusion criteria were recruited from the Department of Endocrinology, Nanfang Hospital between January 2016 and June 2016. These patients were placed in groups based on urinary albumin excretion rate (UAER) and estimated glomerular filtration rate. Nerve conduction studies, the Semmes–Weinstein monofilament test (SWMT) and the vibration perception threshold (VPT) test were conducted. Multiple linear regression analysis, multivariate logistic regression and receiver-operating characteristic (ROC) analysis were performed to investigate the relationship between different stages of diabetic nephropathy and DPN in these patients.ResultsSignificant differences were observed in the conduction velocity (CV) and amplitude of sensory/motor nerve potential among the T2DM patients at different stages of diabetic nephropathy (all p < 0.05). The UAER and duration of diabetes were found to be independent factors associated with the mean CV and amplitude of sensory/motor nerve potential (all p < 0.05). A disease duration of > 10 years (p = 0.025) and a higher total cholesterol value (p = 0.024) were found to be significantly associated with abnormal SWMT results. A UAER of > 300 mg/24 h (p = 0.007) and a diastolic blood pressure of > 100 mmHg (p = 0.042) were associated with a higher risk for abnormal VPT. A UAER of > 300 mg/24 h (p < 0.001) and a disease duration of > 10 years (p = 0.02) were observed to be significantly correlated with DPN. The ROC analysis showed that the optimal cutoff values of UAER and duration as indicators of DPN were 90.5 mg/24 h and 9.5 years, respectively (both p < 0.001).ConclusionsThe results suggest that diabetic nephropathy is closely associated with the development of DPN in T2DM patients and that UAER and disease duration can be used as warning indicators of DPN progression.Chinese Clinical Trials Register NumberChiCTR-ROC-16007701.

Diabetic Peripheral Neuropathy Associated with Cardiovascular Risk Factors and Glucagon-Like Peptide-1 Concentrations Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus

“…Urinary albumin excretion rate can be used as predicting DPN process. [42][43][44] Changes in urine albumin-to-creatinine ratio (≥30%) increase the risk for new-onset DPN in type 2 diabetes (OR = 3.059, 95% CI 1.012-9.249). 45 Furthermore, diabetic retinopathy, especially severe diabetic retinopathy is correlated with DPN; and DPN was a factor like a tell-tale sign of diabetic retinopathy; thus, it is necessary to examine more intensive ophthalmic disease.…”

Serum Albumin Was Negatively Associated With Diabetic Peripheral Neuropathy in Chinese Population: A Cross-sectional Study

“…Our study provided further evidence that supported the potential role of diabetic vasculopathy in the development of DPN, since we found that patients with DPN had higher CysC, Cr, urinary ACR, and lower DBP, eGFR, ABI than those without DPN. Diabetic nephropathy (DN), a complication characterized by a decreased eGFR, increased urinary ACR, and high levels of Cr [30], is one of the most feared diabetic chronic microvascular complications, and is independently associated with DPN [31]. The urinary ACR, a marker of DN, is used as a proxy for damage to the systemic microcirculation and predicts future progression of renal dysfunction and various cardiovascular events in several populations [32].…”

Erectile Dysfunction in Type-2 Diabetes Mellitus Patients: Predictors of Early Detection and Treatment

“…Electrophysiological assessments for DPN in the hospital of this research have been published in previous studies [11]. In brief, the Nicolet VikingQuest electromyograph system (VIASYS Healthcare, Conshohocken, PA, USA) was used for electrophysiological assessments by the same electrophysiologist.…”

“…Taking the negative impact on the family life and social activities into account, early diagnosis and treatment of DMED is essential and may prevent or delay disease progression. Although previous studies have analyzed the risk factors between ED and T2DM, there is no definite prophylactic treatment timing window to make the clinical decision to treat DMED, especially before the onset of clinical symptoms [3,[11][12][13][14][15][16][17][18]. In order to improve the management of DMED, this study was designed not only to offer further data on the risk factors but also to identify a superior cutoff point for early DMED detection and treatment.…”