Diabetes Research Unit, Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Diabetol Metab Syndr. 2012 May 29;4(1):21. doi: 10.1186/1758-5996-4-21.
Prevalence of diabetes mellitus (DM) has reached epidemic proportions in Sri Lanka. Presently there are studies on the community prevalence of distal peripheral neuropathy (DPN) in Sri Lanka. We describe prevalence, patterns and predictors of DPN in patients with DM in Sri Lanka. Data were collected as part of a national study on DM. In new cases DPN was assessed using the Diabetic-Neuropathy-Symptom (DNS) score, while in those with established diabetes both DNS and Toronto-Clinical-Scoring-System (TCSS) were used. A binary logistic-regression analysis was performed with 'presence of DPN' as the dichomatous dependent variable and other independent co-variants. The study included 528 diabetic patients (191-new cases), with a mean age of 55.0 ± 12.4 years and 37.3% were males, while 18% were from urban areas. Prevalence of DPN according to DNS score among all patients, patients with already established diabetes and newly diagnosed patients were 48.1%, 59.1% and 28.8% respectively. Prevalence of DPN in those with established DM as assessed by TCSS was 24% and the majority had mild DPN (16.6%). The remainder of the abstract is based on subjects with established DM. The prevalence of DPN in males and female was 20.0% and 26.4% respectively. The mean age of those with and without DPN was 62.1 ± 10.8 and 55.1 ± 10.8 years respectively (p < 0.001). The majority of those with DPN were from rural-areas (75.3%) and earned a monthly income < Sri Lankan Rupees 12,000 (87.6%). In the binary logistic-regression presence of foot ulcers (OR:10.4; 95%CI 1.8-16.7), female gender (OR:6.7; 95%CI 2.0-9.8) and smoking (OR:5.9; 95%CI 1.4-9.7) were the strongest predictors followed by insulin treatment (OR:4.3; 95%CI 1.3-6.9), diabetic retinopathy (OR:2.7; 95%CI 1.3-5.4), treatment with sulphonylureas (OR:1.8; 95%CI 1.1-3.2), increasing height (OR:1.8; 95%CI 1.2-2.4), rural residence (OR:1.8; 95%CI 1.1-2.5), higher levels of triglycerides (OR:1.6; 95%CI 1.2-2.0) and longer duration of DM (OR:1.2; 95%CI 1.1-1.3). There is a high prevalence of DPN among Sri Lankan adults with diabetes. The study defines the impact of previously known risk factors for development of DPN and identifies several new potential risk factors in an ethnically different large subpopulation with DM.
在斯里兰卡，糖尿病（DM）的患病率已达到流行程度。目前，斯里兰卡有关于远端周围神经病变（DPN）社区患病率的研究。我们描述了斯里兰卡 DM 患者中 DPN 的患病率、模式和预测因素。数据是作为一项关于 DM 的全国性研究的一部分收集的。在新病例中，使用糖尿病神经病变症状（DNS）评分评估 DPN，而在已确诊的糖尿病患者中，同时使用 DNS 和多伦多临床评分系统（TCSS）。使用“存在 DPN”作为二项因变量和其他独立协变量进行二元逻辑回归分析。该研究包括 528 名糖尿病患者（191 名新病例），平均年龄为 55.0±12.4 岁，37.3%为男性，18%来自城市地区。所有患者、已确诊糖尿病患者和新诊断患者中，根据 DNS 评分评估的 DPN 患病率分别为 48.1%、59.1%和 28.8%。根据 TCSS 评估，已确诊 DM 患者中 DPN 的患病率为 24%，大多数患者为轻度 DPN（16.6%）。摘要的其余部分基于已确诊 DM 的患者。男性和女性 DPN 的患病率分别为 20.0%和 26.4%。有和没有 DPN 的患者的平均年龄分别为 62.1±10.8 和 55.1±10.8 岁（p<0.001）。大多数有 DPN 的患者来自农村地区（75.3%），月收入低于斯里兰卡卢比 12000 元（87.6%）。在二元逻辑回归中，足部溃疡（OR：10.4；95%CI 1.8-16.7）、女性（OR：6.7；95%CI 2.0-9.8）和吸烟（OR：5.9；95%CI 1.4-9.7）是最强的预测因素，其次是胰岛素治疗（OR：4.3；95%CI 1.3-6.9）、糖尿病视网膜病变（OR：2.7；95%CI 1.3-5.4）、磺脲类药物治疗（OR：1.8；95%CI 1.1-3.2）、身高增加（OR：1.8；95%CI 1.2-2.4）、农村居住（OR：1.8；95%CI 1.1-2.5）、甘油三酯水平升高（OR：1.6；95%CI 1.2-2.0）和 DM 病程延长（OR：1.2；95%CI 1.1-1.3）。斯里兰卡成年糖尿病患者中 DPN 的患病率很高。该研究定义了先前已知的 DPN 发展危险因素的影响，并在一个种族不同的大型 DM 亚群中确定了几个新的潜在危险因素。
