Longitudinal patient-oriented outcomes in neuropathy

Callaghan, Brian C.; Kerber, Kevin A.; Langa, Kenneth M.; Banerjee, Mousumi; Rodgers, Ann; McCammon, Ryan J.; Burke, James F.; Feldman, Eva L.

doi:10.1212/wnl.0000000000001714

Cited by 42 publications

(27 citation statements)

References 29 publications

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“…This common condition causes significant morbidity and is associated with pain, falls, and reduced quality of life (3,4). While diabetes is by far the number one cause, enhanced glucose control is only marginally effective at reducing the incidence in patients with type 2 diabetes (5).…”

Section: Introductionmentioning

confidence: 99%

Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status

et al. 2016

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OBJECTIVEPrevious studies demonstrate that the metabolic syndrome is associated with distal symmetric polyneuropathy (DSP). We aimed to determine the magnitude of this effect and the precise components involved.RESEARCH DESIGN AND METHODSWe determined the symptomatic DSP prevalence in the Health, Aging, and Body Composition (Health ABC) study (prospective cohort study, with subjects aged 70–79 years at baseline), stratified by glycemic status (glucose tolerance test) and the number of additional metabolic syndrome components (updated National Cholesterol Education Program/Adult Treatment Panel III definition). DSP was defined as neuropathic symptoms (questionnaire) plus at least one of three confirmatory tests (heavy monofilament, peroneal conduction velocity, and vibration threshold). Multivariable logistic and linear regression evaluated the association of metabolic syndrome components with DSP in cross-sectional and longitudinal analyses.RESULTSOf 2,382 participants with neuropathy measures (mean age 73.5 ± 2.9 years, 38.2% black, 51.7% women), 21.0% had diabetes, 29.9% prediabetes, 52.8% metabolic syndrome, and 11.1% DSP. Stratified by glycemic status, DSP prevalence increased as the number of metabolic syndrome components increased (P = 0.03). Diabetes (cross-sectional model, odds ratio [OR] 1.65 [95% CI 1.18–2.31]) and baseline hemoglobin A1C (longitudinal model, OR 1.42 [95% CI 1.15–1.75]) were the only metabolic syndrome measures significantly associated with DSP. Waist circumference and HDL were significantly associated with multiple secondary neuropathy outcomes.CONCLUSIONSIndependent of glycemic status, symptomatic DSP is more common in those with additional metabolic syndrome components. However, the issue of which metabolic syndrome components drive this association, in addition to hyperglycemia, remains unclear. Larger waist circumference and low HDL may be associated with DSP, but larger studies with more precise metabolic measures are needed.

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Section: Introductionmentioning

confidence: 99%

Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status

et al. 2016

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“…DPN is associated with pain, falls, disability, and a reduced quality of life (3, 4). Patients present with distal symmetric polyneuropathy, a slowly progressing and length-dependent, axonal neuropathy.…”

Section: Introductionmentioning

confidence: 99%

Mediators of diabetic neuropathy: is hyperglycemia the only culprit?

Grisold

Callaghan

Feldman

2017

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of this review Diabetic peripheral neuropathy (DPN) is a disabling, highly prevalent complication of both type 1 and type 2 diabetes mellitus (T1DM, T2DM). Large clinical studies support the concept that, in addition to hyperglycemia, components of the metabolic syndrome (MetS) may underlie the pathogenesis of DPN, especially in T2DM. This review will present the evidence supporting the MetS and its individual components as potential causal factors for the development of neuropathy. Recent findings In addition to poor glycemic control and duration of diabetes, components of MetS such as dyslipidemia, obesity, and hypertension, may have an important impact on the prevalence of DPN. Obesity and prediabetes have the most data to support their role in neuropathy, whereas hypertension and dyslipidemia have more mixed results. Non-metabolic factors, such as genetic susceptibility, age, height, gender, smoking, and alcohol, have also been highlighted as potential risk factors in peripheral neuropathy, although the exact contribution of these factors to DPN remains unknown. Summary DPN is a chronic and disabling disease, and the accurate identification and modification of DPN risk factors is important for clinical management. Recent data support a role for components of the MetS and other risk factors in the development of DPN, offering novel targets beyond hyperglycemia for therapeutic development.

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“…Dieses Zusammenspiel neuronaler und muskulärer Faktoren als Ursache der Muskelschwäche im Alter fand unter dem Terminus Dynapenie Eingang in die Literatur [8]. Daraus resultieren -zusätzlich beeinflusst von zentralen Alterungsphänomenen -funktionelle Einschränkungen wie reduzierte Mobilität und erhöhtes Sturzrisiko [5,37].…”

Section: Veränderungen Des Peripheren Nervensystemsunclassified

Polyneuropathie im Alter

Löscher

Iglseder

2020

Internist

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ZusammenfassungDas periphere Nervensystem ist im Laufe des Alternsprozesses Veränderungen unterworfen. So kommt es unter anderem zu einer Abschwächung von Muskeleigenreflexen und Propriozeption. Davon abzugrenzen sind Polyneuropathien als krankhafte Veränderungen des peripheren Nervensystems. Die jährliche Inzidenz von Polyneuropathien wird auf 118/100.000 geschätzt, die Prävalenz liegt bei etwa 1 %, für ältere Populationen werden 7 % angegeben. Die Ursachen sind vielfältig und ähnlich den Ursachen von Neuropathien des jüngeren Alters: Neben metabolischen, immunvermittelten, hereditären, toxischen und infektiösen Ätiologien können Polyneuropathien Ausdruck von Systemerkrankungen sein. Entsprechend der Altersverteilung der verschiedenen Ursachen sind Neuropathien im Zusammenhang mit Diabetes, monoklonalen Gammopathien und Malignomen im Alter häufiger. Allerdings nimmt der Anteil der kryptogenen Neuropathien, also ohne eindeutige Ursache, mit dem Alter zu. Bei alten Menschen führen Polyneuropathien zu einer zusätzlichen Beeinträchtigung der Mobilität und einem erhöhten Sturzrisiko, was auch die Abklärung funktioneller Fähigkeiten erforderlich macht.

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Longitudinal patient-oriented outcomes in neuropathy

Cited by 42 publications

References 29 publications

Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status

Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status

Mediators of diabetic neuropathy: is hyperglycemia the only culprit?

Polyneuropathie im Alter

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