Sztanek Ferenc, Pető Attila, Tóth László Imre, Lőrincz Hajnalka, Molnár Ágnes, Lukács Miklós, Menyhárt Adrienn, Kempler Péter, Paragh György, Harangi Mariann, Nagy Attila Csaba
Department of Internal Medicine, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary.
Third Department of Internal Medicine, Semmelweis Hospital of Borsod-Abauj-Zemplen County Central Hospital and University Teaching Hospital, H-3515 Miskolc, Hungary.
J Clin Med. 2025 Aug 15;14(16):5780. doi: 10.3390/jcm14165780.
: Diabetic sensorimotor polyneuropathy (DSPN) is a frequent microvascular complication of diabetes mellitus, associated with increased morbidity and reduced quality of life. The existing literature offers a limited understanding of sex-specific cardiovascular risk profiles and their association with DSPN, particularly within Central and Eastern European populations. : A retrospective analysis was conducted using data from 621 individuals with type 1 or type 2 diabetes mellitus who underwent comprehensive neuropathy screening at the University of Debrecen between 2017 and 2021. The diagnosis of DSPN was made in accordance with international criteria, incorporating symptom scores, and electrophysiological measurements. Multivariate logistic regression was applied in order to identify independent predictors. : The diagnosis of DSPN was made in 444 individuals (71.5%), of whom 58.2% were female. Despite similar glycemic control (HbA1c: 7.81% in men vs. 7.65% in women, = 0.297), men had significantly more frequent occurrences of previous myocardial infarction (11.8% vs. 5.0%, = 0.008), peripheral vascular disease (19.9% vs. 12.7%, = 0.041) and atherosclerosis (31.7% vs. 22.0%, = 0.021). Multivariate analysis showed that female gender was independently associated with a lower incidence of DSPN (odds ratio [OR] = 0.592, 95% confidence interval [CI]: 0.369-0.950, = 0.030), while diabetic retinopathy was a significant predictor (OR = 2.728, 95% CI: 1.300-5.725, = 0.008). Electrophysiological testing revealed lower nerve conduction amplitudes in females for selected nerves. : Our findings highlight sex-specific differences in neuropathy risk and support the implementation of individualized screening strategies in diabetic populations with region-specific risk factors.
糖尿病感觉运动性多发神经病变（DSPN）是糖尿病常见的微血管并发症，与发病率增加及生活质量下降相关。现有文献对性别特异性心血管风险概况及其与DSPN的关联了解有限，尤其是在中东欧人群中。
一项回顾性分析采用了2017年至2021年期间在德布勒森大学接受全面神经病变筛查的621例1型或2型糖尿病患者的数据。DSPN的诊断依据国际标准，包括症状评分和电生理测量。应用多因素逻辑回归以确定独立预测因素。
444例（71.5%）患者被诊断为DSPN，其中58.2%为女性。尽管血糖控制情况相似（男性糖化血红蛋白[HbA1c]为7.81%，女性为7.65%，P = 0.297），但男性既往心肌梗死发生率显著更高（11.8%对5.0%，P = 0.008），外周血管疾病发生率（19.9%对12.7%，P = 0.041）和动脉粥样硬化发生率（31.7%对22.0%，P = 0.021）也更高。多因素分析显示，女性性别与DSPN发病率较低独立相关（比值比[OR]=0.592，95%置信区间[CI]：0.369 - 0.950，P = 0.030），而糖尿病视网膜病变是一个显著预测因素（OR = 2.728，95%CI：1.300 - 5.725，P = 0.008）。电生理测试显示，女性某些神经的神经传导幅度较低。
我们的研究结果突出了神经病变风险的性别特异性差异，并支持在具有地区特异性风险因素的糖尿病患者群体中实施个体化筛查策略。
