Department of Internal Medicine, Jiyugaoka Medical Clinic, Obihiro, Japan.
Medical Affairs Department, Shionogi & Co., Ltd, Osaka, Japan.
J Diabetes Investig. 2020 Mar;11(2):450-457. doi: 10.1111/jdi.13117. Epub 2019 Aug 6.
AIMS/INTRODUCTION: To assess the prevalence of diabetic polyneuropathy (DPN)-related sensory symptoms/signs and associated factors in patients with polyneuropathy, considering non-linear effects for numerical variables.
A cross-sectional survey of patients with type 2 diabetes mellitus from 17 primary care clinics across Japan was carried out. DPN and DPN-related sensory symptoms/signs were diagnosed according to the Diabetic Neuropathy Study Group in Japan criteria.
Of the 9,914 patients with type 2 diabetes mellitus in this study, 2,745 had DPN and 1,689 had DPN-related sensory symptoms/signs (61.5% of patients with DPN). There were significant correlations between DPN-related sensory symptoms/signs and smoking status (odds ratio 2.04 for current and 1.64 for former; P < 0.001 and P = 0.002, respectively), sex (odds ratio 0.56 for male/female; P < 0.001) and alcohol consumption (odds ratio 2.02 for former/never; P = 0.004). Based on the non-linear logistic regression model, significant correlations were observed between the presence of DPN-related sensory symptoms/signs and higher systolic blood pressure (SBP), longer diabetes duration, and decreasing age. The logarithm of odds for SBP increased until reaching approximately 130 mmHg, then it plateaued.
Some modifiable factors assessed in the large survey database might be associated with DPN-related sensory symptoms/signs, namely smoking, alcohol consumption and SBP. Maintaining SBP <130 mmHg was associated with lower odds of DPN-related sensory symptoms/signs in patients with DPN.
目的/引言:评估日本 17 家初级保健诊所的 2 型糖尿病患者中多发性神经病(DPN)相关感觉症状/体征的患病率和相关因素,同时考虑数值变量的非线性效应。
对日本 17 家初级保健诊所的 2 型糖尿病患者进行横断面调查。根据日本糖尿病神经病变研究组的标准诊断 DPN 和 DPN 相关感觉症状/体征。
在这项研究的 9914 名 2 型糖尿病患者中,2745 名患有 DPN,1689 名患有 DPN 相关感觉症状/体征(61.5%的 DPN 患者)。DPN 相关感觉症状/体征与吸烟状况(当前吸烟的比值比为 2.04,既往吸烟的比值比为 1.64;P<0.001 和 P=0.002)、性别(男性/女性的比值比为 0.56;P<0.001)和饮酒(既往饮酒/从不饮酒的比值比为 2.02;P=0.004)存在显著相关性。基于非线性逻辑回归模型,DPN 相关感觉症状/体征的存在与较高的收缩压(SBP)、较长的糖尿病病程和年龄降低显著相关。SBP 的优势对数在达到约 130mmHg 之前呈上升趋势,然后趋于平稳。
在大型调查数据库中评估的一些可改变因素可能与 DPN 相关感觉症状/体征相关,即吸烟、饮酒和 SBP。维持 SBP<130mmHg 与 DPN 患者 DPN 相关感觉症状/体征的几率降低相关。