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台湾2型糖尿病成年患者中伴或不伴神经性疼痛的糖尿病周围神经病变的患病率及生化危险因素

Prevalence and biochemical risk factors of diabetic peripheral neuropathy with or without neuropathic pain in Taiwanese adults with type 2 diabetes mellitus.

作者信息

Pai Yen-Wei, Lin Ching-Heng, Lee I-Te, Chang Ming-Hong

机构信息

Neurological Institute, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan.

Department of Medical Research, Taichung Veterans General Hospital, No. 1650, Taiwan Boulevard, Sec. 4, Taichung City 40705, Taiwan.

出版信息

Diabetes Metab Syndr. 2018 Apr-Jun;12(2):111-116. doi: 10.1016/j.dsx.2017.09.013. Epub 2017 Sep 28.

Abstract

AIMS

To investigate the prevalence and risk factors for diabetic peripheral neuropathy with or without neuropathic pain in Taiwanese.

METHODS

A cross-sectional, hospital-based observational study was conducted. We enrolled 2837 adults with type 2 diabetes mellitus. Diabetic peripheral neuropathy with or without pain were diagnosed using 2 validated screening tools, namely the Michigan Neuropathy Screening Instrument and Douleur Neuropathique 4 questionnaire.

RESULTS

In our sample, 2233 participants had no neuropathy, 476 had diabetic peripheral neuropathy without pain, and 128 had diabetic peripheral neuropathy with neuropathic pain, representing an overall diabetic peripheral neuropathy prevalence of 21.3%, and the prevalence of neuropathic pain in diabetic peripheral neuropathy was 21.2%. Multivariate analysis revealed that older age (P<0.001), treatment with insulin (P=0.004), microalbuminuria (P=0.001) or overt proteinuria (P<0.001) were independently associated with diabetic peripheral neuropathy, whereas older age (P<0.001), elevated glycated haemoglobin (P=0.011), lower high-density lipoprotein cholesterol (P=0.033), and overt proteinuria (P<0.001) were independently associated with diabetic peripheral neuropathy with neuropathic pain.

CONCLUSIONS

During clinical visits involving biochemical studies, the risk for diabetic peripheral neuropathy with neuropathic pain should be considered for people with older age, elevated glycated haemoglobin, low high-density lipoprotein cholesterol and overt proteinuria, with particular attention given to increased levels of albuminuria while concerning neuropathic pain.

摘要

目的

调查台湾地区糖尿病周围神经病变伴或不伴神经病理性疼痛的患病率及危险因素。

方法

进行了一项基于医院的横断面观察性研究。我们纳入了2837名2型糖尿病成年人。使用两种经过验证的筛查工具,即密歇根神经病变筛查量表和神经病理性疼痛4问卷,诊断糖尿病周围神经病变伴或不伴疼痛。

结果

在我们的样本中,2233名参与者没有神经病变,476名有糖尿病周围神经病变但无疼痛,128名有糖尿病周围神经病变伴神经病理性疼痛,糖尿病周围神经病变的总体患病率为21.3%,糖尿病周围神经病变中神经病理性疼痛的患病率为21.2%。多变量分析显示,年龄较大(P<0.001)、使用胰岛素治疗(P=0.004)、微量白蛋白尿(P=0.001)或显性蛋白尿(P<0.001)与糖尿病周围神经病变独立相关,而年龄较大(P<0.001)、糖化血红蛋白升高(P=0.011)、高密度脂蛋白胆固醇降低(P=0.033)和显性蛋白尿(P<0.001)与糖尿病周围神经病变伴神经病理性疼痛独立相关。

结论

在涉及生化研究的临床就诊期间,对于年龄较大、糖化血红蛋白升高、高密度脂蛋白胆固醇低和显性蛋白尿的患者,应考虑糖尿病周围神经病变伴神经病理性疼痛的风险,在关注神经病理性疼痛时尤其要注意蛋白尿水平的升高。

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