Prevalence of Peripheral Polyneuropathy Before and After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

Machado, Fernanda Dapper; Nienov, Otto Henrique; Schmid, Helena

doi:10.1007/s11695-021-05606-4

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“…Bariatric surgery in people with obesity with and without T2D is associated with improved biomarkers of neuropathy, specifically evidence of small nerve fibre regeneration over 12 months [40,41] evaluated with corneal confocal microscopy. The prevalence of peripheral neuropathy measured with the Michigan Neuropathy Screening Instrument (MNSI) was found to be reduced (pre-bariatric surgery 20.4% to post-bariatric surgery 10.5%) approximately 10 years after Roux-en-Y gastric bypass and sleeve gastrectomy [47]. Several randomized controlled studies (DiRECT, DROPLET and PREVIEW) have demonstrated the efficacy of low-calorie diets (LCDs; 800-850 kcal/day) in severe obesity [48][49][50]; and recently, a dietary weight loss study of 800 kcal/day (for 12 weeks) followed by 1200-1500 kcal/day resulted in an improvement in metabolic parameters, whilst intraepidermal nerve fibre density (IENFD) remained stable after 2 years [51].…”

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confidence: 99%

The Peripheral Neuropathy Prevalence and Characteristics Are Comparable in People with Obesity and Long-Duration Type 1 Diabetes

et al. 2022

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Introduction: Peripheral neuropathy is reported in obesity even in the absence of hyperglycaemia.Objective: To compare the prevalence and characterise the phenotype of peripheral neuropathy in people living with obesity (OB) and long-duration type 1 diabetes (T1D). Patients and Methods:We performed a prospective cross-sectional study of 130 participants including healthy volunteers (HV) (n = 28), people with T1D (n = 51), and OB (BMI 30-50 kg/m 2 ) (n = 51). Participants underwent assessment of neuropathic symptoms (Neuropathy Symptom Profile, NSP), neurological deficits (Neuropathy Disability Score, NDS), vibration perception threshold (VPT) and evaluation of sural nerve conduction velocity and amplitude.Results: Peripheral neuropathy was present in 43.1% of people with T1D (age 49.9 ± 12.9 years; duration of diabetes 23.4 ± 13.5 years) and 33.3% of OB (age 48.2 ± 10.8 years). VPT for high risk of neuropathic foot ulceration (VPT C 25 V) was present in 31.4% of T1D and 19.6% of OB. Participants living with OB were heavier (BMI 42.9 ± 3.5 kg/m 2 ) and had greater centripetal adiposity with an increased body fat percentage (FM%) (P \ 0.001) and waist circumference (WC) (P \ 0.001) compared to T1D. The OB group had a higher NDS (P \ 0.001), VAS for pain (P \ 0.001), NSP (P \ 0.001), VPT (P \ 0.001) and reduced sural nerve conduction velocity (P \ 0.001) and amplitude (P \ 0.001) compared to HV, but these parameters were comparable in T1D. VPT was positively associated with increased WC (P = 0.011), FM% (P = 0.001) and HbA1c (P \ 0.001) after adjusting for age (R 2 = 0.547). Subgroup analysis of respiratory quotient (RQ) measured in the OB group did not correlate with VPT (P = 0.788), J. P. H. Wilding and Uazman Alam are joint senior authors.

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