Chew Sher Mein, Dua Avinashi Sanchi, Venkataraman Kavita
Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, #10-03J, Level 10, Tahir Foundation Building (MD1), 12 Science Drive 2, Singapore, 117549, Singapore.
Rev Endocr Metab Disord. 2025 Jun 3. doi: 10.1007/s11154-025-09973-6.
Diabetic peripheral neuropathy (DPN) is a debilitating complication of diabetes, with limited treatment options. This systematic review consolidates longitudinal studies on the development of DPN, identifying key predictors to inform clinical interventions for DPN prevention. PubMed, Embase, and Cochrane databases were searched for peer-reviewed studies on DPN published before March 2024. Longitudinal studies involving populations with diabetes and investigating sociodemographic, lifestyle, anthropometric, and clinical predictors of DPN were included. Studies with missing data or high risk of bias were excluded. Predictors of DPN were extracted from included studies and recorded in an Excel file. Weighted mean differences (continuous variables) and relative risks (dichotomous variables) were calculated to assess predictors' significance. Twenty-seven studies analyzing 21 predictors were included. The median sample size and follow-up time were 985 and 72 months respectively. Age, HbA1c, BMI, diabetes duration, and systolic blood pressure were strong positive predictors of incident DPN, highlighting the role of glycemic control, weight management, and blood pressure optimization in reducing DPN risk. Modest associations were found for fasting plasma glucose, smoking, height, weight, waist circumference, sex, use of antihyperlipidemia drugs, and retinopathy. A subgroup analysis demonstrated that these findings were relevant to both Type 1 and Type 2 diabetes. Despite the heterogeneity observed in DPN diagnostic criteria and measurements of predictors across studies, several potentially modifiable risk factors for DPN were identified. These findings can help healthcare providers identify high-risk individuals and implement appropriate preventive measures targeting these factors for reducing the risk of DPN development.
糖尿病周围神经病变（DPN）是糖尿病一种使人衰弱的并发症，治疗选择有限。本系统评价整合了关于DPN发生发展的纵向研究，确定关键预测因素，为DPN预防的临床干预提供依据。检索了PubMed、Embase和Cochrane数据库，查找2024年3月之前发表的关于DPN的同行评审研究。纳入涉及糖尿病患者群体并调查DPN的社会人口学、生活方式、人体测量学和临床预测因素的纵向研究。排除数据缺失或偏倚风险高的研究。从纳入研究中提取DPN的预测因素并记录在Excel文件中。计算加权平均差（连续变量）和相对风险（二分变量）以评估预测因素的显著性。纳入了27项分析21个预测因素的研究。样本量中位数和随访时间分别为985和72个月。年龄、糖化血红蛋白（HbA1c）、体重指数（BMI）、糖尿病病程和收缩压是新发DPN的强阳性预测因素，突出了血糖控制、体重管理和血压优化在降低DPN风险中的作用。空腹血糖、吸烟、身高、体重、腰围、性别、使用抗高血脂药物和视网膜病变之间存在适度关联。亚组分析表明，这些发现与1型和2型糖尿病均相关。尽管在各研究中DPN诊断标准和预测因素测量存在异质性，但仍确定了几个DPN潜在的可改变风险因素。这些发现可帮助医疗保健提供者识别高危个体，并针对这些因素实施适当的预防措施，以降低DPN发生风险。
