Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Department of Neurology, National Neuroscience Institute, Singapore.
Muscle Nerve. 2022 May;65(5):593-598. doi: 10.1002/mus.27484. Epub 2022 Jan 22.
INTRODUCTION/AIMS: Recently, our group found an association between diabetes mellitus (DM) and lumbosacral radiculoplexus neuropathy (LRPN) in Olmsted County, Minnesota; we found a higher risk (odds ratio [OR], 7.91) for developing LRPN in diabetic compared with nondiabetic patients. However, the influence of other comorbidities and anthropomorphic variables was not studied.
Demographic and clinical data from 59 LRPN patients and 177 age/sex-matched controls were extracted using the Rochester LRPN epidemiological study. Differences between groups were compared by chi-square/Fisher exact test or Wilcoxon rank-sum test. Uni- and multivariate logistic regression analysis were performed.
Factors predictive of LRPN on univariate analysis were DM (OR, 7.91; 95% confidence interval [CI], 4.11-15.21), dementia (OR, 6.36; 95% CI, 1.13-35.67), stroke (OR, 3.81; 95% CI, 1.32-11.01), dyslipidemia (OR, 2.844; 95% CI, 1.53-5.27), comorbid autoimmune disorders (OR, 2.72; 95% CI, 1.07-6.93), hypertension (OR, 2.25; 95% CI, 1.2-4.13), obesity (OR, 2.05; 95% CI, 1.11-3.8), body mass index (BMI) (OR, 1.1; 95% CI, 1.04-1.15), and weight (OR, 1.02; 95% CI, 1.009-1.037). On multivariate logistic regression analysis only DM (OR, 8.03; 95% CI, 3.86-16.7), comorbid autoimmune disorders (OR, 4.58; 95% CI, 1.45-14.7), stroke (OR, 4.13; 95% CI, 1.2-14.25), and BMI (OR, 1.07; 95% CI, 1.01-1.13) were risk factors for LRPN.
DM is the strongest risk factor for the development of LRPN, followed by comorbid autoimmune disorders, stroke, and higher BMI. Altered metabolism and immune dysfunction seem to be the most influential factors in the development of LRPN.
简介/目的:最近,我们小组在明尼苏达州的奥姆斯特德县发现了糖尿病(DM)与腰骶神经根丛神经病(LRPN)之间的关联;我们发现糖尿病患者发生 LRPN 的风险高于非糖尿病患者(优势比[OR],7.91)。然而,我们并未研究其他合并症和人体测量学变量的影响。
使用罗切斯特 LRPN 流行病学研究,提取了 59 例 LRPN 患者和 177 例年龄/性别匹配对照者的人口统计学和临床数据。使用卡方/Fisher 确切检验或 Wilcoxon 秩和检验比较组间差异。进行单变量和多变量逻辑回归分析。
单变量分析提示 LRPN 的预测因素包括糖尿病(OR,7.91;95%置信区间[CI],4.11-15.21)、痴呆(OR,6.36;95%CI,1.13-35.67)、中风(OR,3.81;95%CI,1.32-11.01)、血脂异常(OR,2.844;95%CI,1.53-5.27)、合并自身免疫性疾病(OR,2.72;95%CI,1.07-6.93)、高血压(OR,2.25;95%CI,1.2-4.13)、肥胖(OR,2.05;95%CI,1.11-3.8)、体重指数(BMI)(OR,1.1;95%CI,1.04-1.15)和体重(OR,1.02;95%CI,1.009-1.037)。多变量逻辑回归分析仅提示糖尿病(OR,8.03;95%CI,3.86-16.7)、合并自身免疫性疾病(OR,4.58;95%CI,1.45-14.7)、中风(OR,4.13;95%CI,1.2-14.25)和 BMI(OR,1.07;95%CI,1.01-1.13)是 LRPN 的危险因素。
糖尿病是发生 LRPN 的最强危险因素,其次是合并自身免疫性疾病、中风和较高的 BMI。代谢改变和免疫功能障碍似乎是 LRPN 发展的最主要影响因素。