The International Diabetic Neuropathy Consortium (IDNC), Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
Department of Clinical Medicine, Danish Pain Research Center, Aarhus University, Aarhus, Denmark.
Pain. 2020 Mar;161(3):574-583. doi: 10.1097/j.pain.0000000000001744.
Most studies of diabetic polyneuropathy (DPN) and painful DPN are conducted in persons with longstanding diabetes. This cross-sectional study aimed to estimate the prevalence of DPN and painful DPN, important risk factors, and the association with mental health in recently diagnosed type 2 diabetes. A total of 5514 (82%) patients (median diabetes duration 4.6 years) enrolled in the Danish Centre for Strategic Research in Type 2 Diabetes cohort responded to a detailed questionnaire on neuropathy and pain. A score ≥4 on the MNSI questionnaire determined possible DPN, whereas pain presence in both feet together with a score ≥3 on the DN4 questionnaire determined possible painful DPN. The prevalence of possible DPN and possible painful DPN was 18% and 10%, respectively. Female sex, age, diabetes duration, body mass index, and smoking were associated with possible DPN, whereas only smoking showed a clear association with possible painful DPN (odds ratio 1.52 [95% confidence interval: 1.20-1.93]). Possible DPN and painful DPN were independently and additively associated with lower quality of life, poorer sleep, and symptoms of depression and anxiety. Possible DPN itself had greater impact on mental health than neuropathic pain. This large study emphasizes the importance of careful screening for DPN and pain early in the course of type 2 diabetes.
大多数糖尿病多发性神经病变(DPN)和痛性 DPN 的研究都是在长期患有糖尿病的人群中进行的。本横断面研究旨在评估新诊断 2 型糖尿病患者中 DPN 和痛性 DPN 的患病率、重要的危险因素,以及与心理健康的关系。丹麦 2 型糖尿病战略研究中心的队列中共有 5514 名(82%)患者(中位糖尿病病程 4.6 年)对神经病变和疼痛的详细问卷做出了回应。MNSI 问卷得分≥4 确定可能存在 DPN,而双脚疼痛且 DN4 问卷得分≥3 确定可能存在痛性 DPN。可能存在 DPN 和可能存在痛性 DPN 的患病率分别为 18%和 10%。女性、年龄、糖尿病病程、体重指数和吸烟与可能存在 DPN 相关,而只有吸烟与可能存在痛性 DPN 有明显相关性(比值比 1.52 [95%置信区间:1.20-1.93])。可能存在的 DPN 和痛性 DPN 与生活质量下降、睡眠质量差、抑郁和焦虑症状独立且呈累加性相关。可能存在的 DPN 对心理健康的影响大于神经病理性疼痛。这项大型研究强调了在 2 型糖尿病病程早期仔细筛查 DPN 和疼痛的重要性。