Document Detail


Aggregate cardiovascular risk is a stronger statistical correlate of clinically evident diabetic peripheral neuropathy than HbA1c alone.
MedLine Citation:
PMID:  20806682     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mayowa O Owolabi; Arinola Ipadeola; Jokotade O Adeleye
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the National Medical Association     Volume:  102     ISSN:  0027-9684     ISO Abbreviation:  J Natl Med Assoc     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-01     Completed Date:  2010-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7503090     Medline TA:  J Natl Med Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  707-12     Citation Subset:  IM    
Affiliation:
Department of Medicine, University College Hospital, Ibadan, Nigeria. mayowaowolabi@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / 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:
0/Hemoglobin A, Glycosylated

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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