Department of Medicine, Kihoku Hospital, Wakayama Medical University, Wakayama, Japan.
First Department of Medicine, Wakayama Medical University, Wakayama, Japan.
J Diabetes Investig. 2019 Nov;10(6):1565-1575. doi: 10.1111/jdi.13058. Epub 2019 May 14.
AIMS/INTRODUCTION: The prevalence of clinical polyneuropathies (ClinPNs) or nerve conduction abnormality (NCA) in the groups stratified by glucose tolerance, individual components of metabolic syndrome (metabolic syndrome [MetS] components: hypertension, dyslipidemia, obesity) and MetS defined by the International Diabetes Federation consensus was investigated in the Japanese general population. Factors associated with ClinPN and NCA were also identified.
A total of 625 examinees of regional medical checkup programs were recruited to this cross-sectional study. ClinPNs were diagnosed by the Toronto Consensus. NCA was judged by at least one bilateral abnormality of sural nerve action potential amplitude or conduction velocity measured by a point-of-care nerve conduction device (DPNCheck). Clinical factors associated with ClinPNs or NCA were examined by multiple logistic regression analysis. Deteriorating factors of sural nerve action potential amplitude or conduction velocity values were also investigated in participants without diabetes (n = 550).
As for glucose tolerance, ClinPNs or NCA significantly increased only in known diabetes patients compared with other groups. There was no difference between prediabetes and the normal group. The prevalence of ClinPNs and NCA was not significantly related to MetS or MetS' components, except for frequent NCA in obesity. The factors significantly associated with both NCA and ClinPNs were smoking and known diabetes. In non-diabetic participants, aging, tall height and hypertension were significant deteriorating factors of nerve conduction functions.
In Japan, ClinPNs and NCA were increased in known diabetes patients, but did not increase in participants with prediabetes, MetS and MetS' components. Smoking and known diabetes were factors significantly associated with ClinPNs or NCA. Hypertension might be a modifiable deteriorating factor of nerve function.
目的/引言:本研究旨在调查按葡萄糖耐量、代谢综合征(代谢综合征 [MetS] 成分:高血压、血脂异常、肥胖)各成分以及国际糖尿病联合会共识定义的 MetS 分层的人群中临床多发性神经病(ClinPNs)或神经传导异常(NCA)的患病率,并确定与 ClinPNs 和 NCA 相关的因素。
本横断面研究共纳入来自区域体检计划的 625 名受检者。采用多伦多共识诊断 ClinPNs。通过床边神经传导设备(DPNCheck)测量的至少一条腓肠神经动作电位幅度或传导速度的双侧异常来判断 NCA。通过多因素逻辑回归分析检查与 ClinPNs 或 NCA 相关的临床因素。还在无糖尿病的参与者(n=550)中调查了腓肠神经动作电位幅度或传导速度值恶化的因素。
就葡萄糖耐量而言,仅在已知糖尿病患者中,ClinPNs 或 NCA 显著增加,而在其他组中没有差异。在糖尿病前期和正常组之间没有差异。ClinPNs 和 NCA 的患病率与 MetS 或 MetS 成分没有显著关系,除了肥胖与频繁的 NCA 有关。与 NCA 和 ClinPNs 均显著相关的因素是吸烟和已知糖尿病。在非糖尿病参与者中,年龄、身高和高血压是神经传导功能恶化的显著因素。
在日本,已知糖尿病患者的 ClinPNs 和 NCA 增加,但糖尿病前期、MetS 和 MetS 成分的参与者没有增加。吸烟和已知糖尿病是与 ClinPNs 或 NCA 显著相关的因素。高血压可能是神经功能恶化的可改变因素。