Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Cardiology, Department of Internal Medicine, St Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
J Diabetes Investig. 2023 Nov;14(11):1279-1288. doi: 10.1111/jdi.14063. Epub 2023 Jul 30.
AIMS/INTRODUCTION: We investigated the association of polyneuropathy (PN) with all-cause and cardiovascular (CV) mortality and with cardiovascular disease (CVD) events stratified by diabetes status.
This prospective cohort study used the UK Biobank. Polyneuropathy was defined based on nurse-led interviews or ICD codes for polyneuropathy. Cox proportional hazards models were used to investigate the association of polyneuropathy with clinical outcomes.
A total of 459,127 participants were included in the analysis. Polyneuropathy was significantly associated with all-cause and cardiovascular mortality, and with CVD events even after adjusting for CVD risk factors across all diabetes statuses. Metabolic parameters HbA , waist circumference, BMI and the inflammatory parameter C-reactive protein showed significant mediation effects for the association between polyneuropathy and CVD. Adherence to a favorable lifestyle was associated with a lower risk of all-cause and cardiovascular mortality regardless of polyneuropathy status.
Polyneuropathy was associated with all-cause and cardiovascular mortality, and with CVD events in subjects with diabetes or prediabetes, even those having normal glucose tolerance. This study suggests the importance of polyneuropathy as a risk factor for death and highlights the necessity of early diagnosis and lifestyle intervention for those with type 2 diabetes and polyneuropathy.
目的/引言：我们研究了多发性神经病（PN）与全因和心血管（CV）死亡率以及按糖尿病状态分层的心血管疾病（CVD）事件的相关性。
本前瞻性队列研究使用了英国生物库。多发性神经病是根据护士主导的访谈或 ICD 编码定义的。Cox 比例风险模型用于研究多发性神经病与临床结局的相关性。
共有 459127 名参与者纳入分析。多发性神经病与全因和心血管死亡率以及 CVD 事件显著相关，即使在所有糖尿病状态下调整 CVD 危险因素后也是如此。代谢参数 HbA1c、腰围、BMI 和炎症参数 C 反应蛋白对多发性神经病与 CVD 之间的相关性具有显著的中介作用。无论多发性神经病的状态如何，遵循有利的生活方式与全因和心血管死亡率降低相关。
多发性神经病与糖尿病或糖尿病前期患者的全因和心血管死亡率以及 CVD 事件相关，即使这些患者的血糖正常。本研究表明多发性神经病作为死亡风险因素的重要性，并强调了对 2 型糖尿病和多发性神经病患者进行早期诊断和生活方式干预的必要性。
