Relationship of Vascular Factors on Electrophysiologic Severity of Diabetic Neuropathy
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective To investigate the impact of vascular factors on the electrophysiologic severity of diabetic neuropathy (DPN).Methods Total 530 patients with type 2 diabetes were enrolled retrospectively. We rated severity of DPN from 1 (normal) to 4 (severe) based on electrophysiologic findings. We collected the data concerning vascular factors (including brachial-ankle pulse wave velocity [PWV], ankle brachial index, ultrasound of carotid artery, lipid profile from the blood test, and microalbuminuria [MU] within 24 hours urine), and metabolic factors of diabetes (such as glycated hemoglobin [HbA1c]). We analyzed the differences among the four subgroups using 2 test and ANOVA, and ordinal logistic regression analysis was performed to investigate the relationship between significant variables and severity of DPN.Results The severity of DPN was significantly associated with duration of diabetes, HbA1c, existence of diabetic retinopathy and nephropathy, PWV, presence of plaque, low density lipoprotein-cholesterol and MU (p<0.05). Among these variables, HbA1c and presence of plaque were more significantly related with severity of DPN in logistic regression analysis (p<0.001), and presence of plaque showed the highest odds ratio (OR=2.52).Conclusion Our results suggest that markers for vascular wall properties, such as PWV and presence of plaque, are significantly associated with the severity of DPN. The presence of plaque was more strongly associated with the severity of DPN than other variables.
Abstract
Objective To investigate the impact of vascular factors on the electrophysiologic severity of diabetic neuropathy (DPN).Methods Total 530 patients with type 2 diabetes were enrolled retrospectively. We rated severity of DPN from 1 (normal) to 4 (severe) based on electrophysiologic findings. We collected the data concerning vascular factors (including brachial-ankle pulse wave velocity [PWV], ankle brachial index, ultrasound of carotid artery, lipid profile from the blood test, and microalbuminuria [MU] within 24 hours urine), and metabolic factors of diabetes (such as glycated hemoglobin [HbA1c]). We analyzed the differences among the four subgroups using 2 test and ANOVA, and ordinal logistic regression analysis was performed to investigate the relationship between significant variables and severity of DPN.Results The severity of DPN was significantly associated with duration of diabetes, HbA1c, existence of diabetic retinopathy and nephropathy, PWV, presence of plaque, low density lipoprotein-cholesterol and MU (p<0.05). Among these variables, HbA1c and presence of plaque were more significantly related with severity of DPN in logistic regression analysis (p<0.001), and presence of plaque showed the highest odds ratio (OR=2.52).Conclusion Our results suggest that markers for vascular wall properties, such as PWV and presence of plaque, are significantly associated with the severity of DPN. The presence of plaque was more strongly associated with the severity of DPN than other variables.
참고문헌 (40)
- Orchard TJ, "Prevalence of complications in IDDM by sex and duration: Pittsburgh Epidemiology of Diabetes Complications Study II", Diabetes, 39, pp.1116~1124 (1990)
- Maser RE, "Epidemiological correlates of diabetic neuropathy: report from Pittsburgh Epidemiology of Diabetes Complications Study", Diabetes, 38, pp.1456~1461 (1989)
- The Diabetes Control and Complications Trial Research Group, "The effect of intensive diabetes therapy on the development and progression of neuropathy", Ann Intern Med, 122, pp.561~568 (1995)
- 박근영, "말초 혈관 질환이 당뇨병성 신경병증에 미치는 영향", Annals of Rehabilitation Medicine, 30(1), pp.25~32 (2006), 대한재활의학회
- Pyorala K, "Diabetes and atherosclerosis:an epidemiologic view", Diabetes Metab Rev, 3, pp.463~524 (1987)
- Cameron NE, "Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy", Diabetologia, 44, pp.1973~1988 (2001)
- Nukada H, "Mild ischemia causes severe pathological changes in experimental diabetic nerve", Muscle Nerve, 15, pp.1116~1122 (1992)
- Nukada H, "Axonal caliber and neurofilaments are proportionately decreased in galactose neuropathy", J Neuropathol Exp Neurol, 45, pp.140~150 (1986)
- Malik RA, "Hypoxic neuropathy: relevance to human diabetic neuropathy", Diabetologia, 33, pp.311~318 (1990)
- Teunissen LL, "Relationship between ischemia and neuropathy", Eur Neurol, 44, pp.1~7 (2000)
- Cameron NE, "Metabolic and vascular factors in the pathogenesis of diabetic neuropathy", Diabetes, 46(2), pp.S31~S37 (1997)
- Stevens MJ, "The aetiology of diabetic neuropathy: the combined roles of metabolic and vascular defects", Diabet Med, 12, pp.566~579 (1995)
- Dyck PJ, "Diabetic neuropathy" (1999), Saunders
- 권희규, "당뇨병성 신경병증 심도에 따른 수근관 증후군의 동반 빈도", Annals of Rehabilitation Medicine, 29(3), pp.272~275 (2005), 대한재활의학회
- 박은미, "당뇨병성 신경병증의 심한 정도와 미세알부민뇨증의 연관성", Annals of Rehabilitation Medicine, 26(5), pp.11~561 (2002), 대한재활의학회
- Murphy TP, "Ankle-brachial index and cardiovascular risk prediction:an analysis of 11,594 individuals with 10-year follow-up", Atherosclerosis, 220, pp.160~167 (2012)
- Potier L, "Use and utility of ankle brachial index in patients with diabetes", Eur J Vasc Endovasc Surg, 41, pp.110~116 (2011)
- Munakata M, "Brachial-ankle pulse wave velocity in the measurement of arterial stiffness: recent evidence and clinical applications", Curr Hypertens Rev, 10, pp.49~57 (2014)
- Johnsen SH, "Carotid plaque compared with intima-media thickness as a predictor of coronary and cerebrovascular disease", Curr Cardiol Rep, 11, pp.21~27 (2009)
- Tomiyama H, "Influences of age and gender on results of noninvasive brachial-ankle pulse wave velocity measurement: a survey of 12517 subjects", Atherosclerosis, 166, pp.303~309 (2003)
- Xu D, "Diagnostic value of ankle-brachial index in peripheral arterial disease: a meta-analysis", Can J Cardiol, 29, pp.492~498 (2013)
- Kakrani AL, "Clinical and nerve conduction study correlation in patients of diabetic neuropathy", J Assoc Physicians India, 62, pp.24~27 (2014)
- Chaudhry V, "Inter- and intraexaminer reliability of nerve conduction measurements in patients with diabetic neuropathy", Neurology, 44, pp.1459~1462 (1994)
- Bertora P, "Prevalence of subclinical neuropathy in diabetic patients: assessment by study of conduction velocity distribution within motor and sensory nerve fibres", J Neurol, 245, pp.81~86 (1998)
- Hendriksen PH, "Hypoxic neuropathy versus diabetic neuropathy: an electrophysiological study in rats", J Neurol Sci, 110, pp.199~106 (1992)
- Tesfaye S, "Vascular factors in diabetic neuropathy", Diabetologia, 37, pp.847~854 (1994)
- Kato Y, "Diabetic neuropathy", Nihon Rinsho, 73, pp.495~500 (2015)
- Yokoyama H, "Diabetic neuropathy is closely associated with arterial stiffening and thickness in type 2 diabetes", Diabet Med, 24, pp.1329~1335 (2007)
- Kim ES, "Diabetic peripheral neuropathy is associated with increased arterial stiffness without changes in carotid intima-media thickness in type 2 diabetes", Diabetes Care, 34, pp.1403~1405 (2011)
- Simmons Z, "Update on diabetic neuropathy", Curr Opin Neurol, 15, pp.595~603 (2002)
- Tesfaye S, "Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study", Diabetologia, 39, pp.1377~1384 (1996)
- Yambe M, "Arterial stiffening as a possible risk factor for both atherosclerosis and diastolic heart failure", Hypertens Res, 27, pp.625~631 (2004)
- Li Q, "High ankle-brachial index indicates cardiovascular and peripheral arterial disease in patients with type 2 diabetes", Angiology, 66, pp.918~924 (2015)
- Cardoso CR, "Factors associated with carotid intima-media thickness and carotid plaques in type 2 diabetic patients", J Hypertens, 30, pp.940~947 (2012)
- Adams MR, "Carotid intima-media thickness is only weakly correlated with the extent and severity of coronary artery disease", Circulation, 92, pp.2127~2134 (1995)
- Aminbakhsh A, "Detection of early atherosclerosis with B mode carotid ultrasonography:assessment of a new quantitative approach", Clin Invest Med, 22, pp.265~274 (1999)
- Martinsson A, "Carotid plaque, intimamedia thickness, and incident aortic stenosis: a prospective cohort study", Arterioscler Thromb Vasc Biol, 34, pp.2343~2348 (2014)
- Patel KL, "Microalbuminuria in non-insulin dependent diabetes mellitus", J Assoc Physicians India, 47, pp.596~601 (1999)
- Weir MR, "Microalbuminuria and cardiovascular disease", Clin J Am Soc Nephrol, 2, pp.581~590 (2007)
- Birtcher KK, "Measurement of cholesterol:a patient perspective", Circulation, 110, pp.e296~e297 (2004)
