Association between Diabetic Neuropathy with Increased Arterial Stiffening and Thickness in Type 2 Diabetes
Abstract Number: 967-P
Authors: EUN SOOK KIM, CHUL WOO AHN, JEONG SEON YOO, JI SUN NAM, MINHO CHO, JONG SOOK PARK, KYUNG RAE KIM
Institutions: Seoul, Korea, Republic of
Results: Diabetic peripheral neuropathy (DPN) is a common diabetes-related complication. Although several reports suggest interactions between metabolic derangement, vascular factors, and nerve dysfunction, few studies have investigated direct relationship between DPN and atherosclerosis. The aim of this study was to investigate the association between DPN and atherosclerosis by evaluating carotid intima-media thickness (IMT) and cardio-ankle vascular index (CAVI) to assess arterial thickening and stiffness in type 2 diabetic patients.
In 957 patients with Type 2 diabetes (age 58.1 ± 13.9 years and diabetes duration 10.6 ± 9.4 years), DPN was assessed and defined with two or more the following four measures: the presence of neuropathic symptoms, absence of deep tendon reflexes, abnormal 10-g monofilament test and abnormal current perception threshold test.
Of 465 patients with DPN, 33.2 % of patients had significant symptoms (total symptom score ≥ 2). Patients with DPN had higher IMT compared to those without DPN (0.71 ± 0.20 mm vs. 0.67 ± 0.19 mm, P=0.01) and higher CAVI (8.78 ± 1.48 vs. 8.30 ± 8.44, p<0.01), whereas no difference in IMT and CAVI was existed between symptomatic and asymptomatic group. Presence of DPN was positively correlated with age (r=0.09, p<0.01), diabetes duration (r=0.09, p=0.02), BMI (r=-0.08, p=0.01), systolic blood pressure (r=0.07, p=0.03), serum creatinine (r=0.08, p=0.01), IMT (r=0.09, p=0.01) and CAVI (r=0.16, p<0.01). In the multivariate analysis, patients with DPN had higher prevalence of abnormally increased IMT (≥ 1.0 mm) [odds ratio (OR): 3.22, 95% confidence interval (CI): 1.45-7.17) and abnormal CAVI (≥ 9) (OR: 2.04, 95%CI: 1.10-6.01) after adjustment for age, sex and conventional cardiovascular risk factors (BMI, duration, smoking, lipid profiles, hypertension, use of insulin and antihypertensive drugs).
In conclusion, DPN was significantly associated with increased IMT and CAVI independent of established cardiovascular risk factors regardless of symptoms. Careful assessment of DPN could give additional information for discriminating patients at high risk of cardiovascular disease in conjoint with conventional risk factors.