| Aggregate cardiovascular risk is a stronger statistical correlate of clinically evident diabetic peripheral neuropathy than HbA1c alone. | |
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MedLine Citation:
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PMID: 20806682 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Apart from chronic hyperglycemia measured by hemoglobin A1c (HbA1c), other vascular risk factors contribute to the development of diabetic neuropathy. Even though these factors are synergistic, no study has measured the relative effect of aggregate cardiovascular risk load compared with chronic hyperglycemia alone on the risk of clinically evident diabetic peripheral neuropathy. OBJECTIVE: To compare the effects of aggregate cardiovascular risk load and HbA1c on clinically evident diabetic peripheral neuropathy. METHODS: We studied 277 consecutive and consenting type 2 diabetic outpatients attending the University College Hospital, Ibadan, Nigeria. Neuropathy was defined operationally as at least 7 positive responses on the Michigan Neuropathy Screening Instrument (MNSI) questionnaire or a score greater than 2.0 on the MNSI examination: thresholds defined by prior validation studies. Patients with nondiabetic causes of neuropathy were excluded. We determined the HbA1c using the ionic exchange chromatographic method and later computed the Diabetes Control Complications Trial referenced values. Aggregate cardiovascular risk load was determined using the UK Prospective Diabetes Study risk engines. RESULTS: One hundred ninety-seven (71.1%) patients had clinically evident diabetic peripheral neuropathy. The mean HbA1c value was 6.9%. HbA1c correlated significantly with the average fasting plasma glucose (r = 0.36) but did not correlate significantly with the development of clinically evident diabetic peripheral neuropathy (p = .465, p = -0.045). Aggregate cardiovascular risk load had the strongest significant correlation with clinically evident diabetic peripheral neuropathy (p = .002, p = 0.186, odds ratio, 2.3 for score > 5). In the regression analysis, aggregate cardiovascular risk load was a stronger predictor of clinically evident diabetic peripheral neuropathy than HbA1c. CONCLUSIONS: Aggregate cardiovascular risk load was a stronger statistical correlate and predictor of clinically evident diabetic peripheral neuropathy than HbA1c. This may have implications for prevention and monitoring of clinically evident diabetic peripheral neuropathy. |
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Authors:
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Mayowa O Owolabi; Arinola Ipadeola; Jokotade O Adeleye |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the National Medical Association Volume: 102 ISSN: 0027-9684 ISO Abbreviation: J Natl Med Assoc Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-09-01 Completed Date: 2010-09-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7503090 Medline TA: J Natl Med Assoc Country: United States |
Other Details:
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Languages: eng Pagination: 707-12 Citation Subset: IM |
Affiliation:
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Department of Medicine, University College Hospital, Ibadan, Nigeria. mayowaowolabi@yahoo.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiovascular Diseases
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blood* Chi-Square Distribution Diabetes Mellitus, Type 2 / blood Diabetic Neuropathies / blood* Female Hemoglobin A, Glycosylated / analysis* Humans Male Middle Aged Nigeria Questionnaires Regression Analysis Risk Assessment Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobin A, Glycosylated |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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