1. Cardiometabolic risk factors as determinants of peripheral nerve function
- Author
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Miranda T. Schram, Danny M. W. Hilkman, Nicolaas C. Schaper, Jos P. H. Reulen, Werner H. Mess, Ronald M.A. Henry, Carla J.H. van der Kallen, Jeroen H. P. M. van der Velde, Coen D.A. Stehouwer, Hans H.C.M. Savelberg, Casper G. Schalkwijk, Elsa S. Strotmeyer, Annemarie Koster, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Nutrition and Movement Sciences, Sociale Geneeskunde, RS: CAPHRI - R4 - Health Inequities and Societal Participation, MUMC+: HZC Klinische Neurofysiologie (5), Klinische Neurowetenschappen, MUMC+: HZC Med Staf Spec Klinische Neurofys (9), RS: Carim - B06 Imaging, MUMC+: HVC Pieken Maastricht Studie (9), MUMC+: MA Interne Geneeskunde (3), Interne Geneeskunde, MUMC+: Centrum voor Chronische Zieken (3), MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), MUMC+: MA Endocrinologie (9), MUMC+: MA Maag Darm Lever (9), MUMC+: MA Hematologie (9), MUMC+: MA Medische Oncologie (9), MUMC+: MA Nefrologie (9), MUMC+: MA Reumatologie (9), RS: Carim - V01 Vascular complications of diabetes and metabolic syndrome, and RS: CAPHRI - R2 - Creating Value-Based Health Care
- Subjects
Blood Glucose ,Male ,Endocrinology, Diabetes and Metabolism ,Neural Conduction ,Type 2 diabetes ,Impaired glucose tolerance ,0302 clinical medicine ,Diabetic Neuropathies ,Medicine ,Prediabetes ,METABOLIC SYNDROME ,COMPLICATIONS ,NEUROPATHIC PAIN ,Middle Aged ,Electrophysiological ,PREVALENCE ,Electrophysiology ,Nerve conduction test ,OBESITY ,Cardiology ,Female ,SUBCLINICAL INFLAMMATION ,Adult ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Sural nerve ,Article ,03 medical and health sciences ,Vibration perception ,Internal medicine ,Internal Medicine ,Humans ,Peripheral Nerves ,Risk factor ,AUGSBURG SURVEYS S2 ,Aged ,business.industry ,medicine.disease ,Impaired fasting glucose ,Cardiometabolic risk factors ,DIABETIC POLYNEUROPATHY ,DYSFUNCTION ,Neuropathy ,INDIVIDUALS ,Cross-Sectional Studies ,Diabetes status ,The metabolic syndrome ,Metabolic syndrome ,business ,030217 neurology & neurosurgery - Abstract
Aims/hypothesis We aimed to examine associations of cardiometabolic risk factors, and (pre)diabetes, with (sensorimotor) peripheral nerve function. Methods In 2401 adults (aged 40–75 years) we previously determined fasting glucose, HbA1c, triacylglycerol, HDL- and LDL-cholesterol, inflammation, waist circumference, blood pressure, smoking, glucose metabolism status (by OGTT) and medication use. Using nerve conduction tests, we measured compound muscle action potential, sensory nerve action potential amplitudes and nerve conduction velocities (NCVs) of the peroneal, tibial and sural nerves. In addition, we measured vibration perception threshold (VPT) of the hallux and assessed neuropathic pain using the DN4 interview. We assessed cross-sectional associations of risk factors with nerve function (using linear regression) and neuropathic pain (using logistic regression). Associations were adjusted for potential confounders and for each other risk factor. Associations from linear regression were presented as standardised regression coefficients (β) and 95% CIs in order to compare the magnitudes of observed associations between all risk factors and outcomes. Results Hyperglycaemia (fasting glucose or HbA1c) was associated with worse sensorimotor nerve function for all six outcome measures, with associations of strongest magnitude for motor peroneal and tibial NCV, βfasting glucose = −0.17 SD (−0.21, −0.13) and βfasting glucose = −0.18 SD (−0.23, −0.14), respectively. Hyperglycaemia was also associated with higher VPT and neuropathic pain. Larger waist circumference was associated with worse sural nerve function and higher VPT. Triacylglycerol, HDL- and LDL-cholesterol, and blood pressure were not associated with worse nerve function; however, antihypertensive medication usage (suggestive of history of exposure to hypertension) was associated with worse peroneal compound muscle action potential amplitude and NCV. Smoking was associated with worse nerve function, higher VPT and higher risk for neuropathic pain. Inflammation was associated with worse nerve function and higher VPT, but only in those with type 2 diabetes. Type 2 diabetes and, to a lesser extent, prediabetes (impaired fasting glucose and/or impaired glucose tolerance) were associated with worse nerve function, higher VPT and neuropathic pain (p for trend Conclusions/interpretation Hyperglycaemia (including the non-diabetic range) was most consistently associated with early-stage nerve damage. Nonetheless, larger waist circumference, inflammation, history of hypertension and smoking may also independently contribute to worse nerve function.
- Published
- 2020