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Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years: ADDITION-Denmark

OBJECTIVE To study incident diabetic polyneuropathy (DPN) prospectively during the first 13 years after a screening-based diagnosis of type 2 diabetes and determine the associated risk factors for the development of DPN. - RESEARCH DESIGN AND METHODS We assessed DPN longitudinally in the Danish arm...

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Main Authors: Andersen, Signe Toft (Author) , Witte, Daniel R. (Author) , Dalsgaard, Else-Marie (Author) , Andersen, Henning (Author) , Nawroth, Peter Paul (Author) , Fleming, Thomas (Author) , Jensen, Troels M. (Author) , Finnerup, Nanna B. (Author) , Jensen, Troels S. (Author) , Lauritzen, Torsten (Author) , Feldman, Eva L. (Author) , Callaghan, Brian C. (Author) , Charles, Morten (Author)
Format: Article (Journal)
Language:English
Published: 6 February 2018
In: Diabetes care
Year: 2018, Volume: 41, Issue: 5, Pages: 1068-1075
ISSN:1935-5548
DOI:10.2337/dc17-2062
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.2337/dc17-2062
Verlag, lizenzpflichtig, Volltext: https://care.diabetesjournals.org/content/41/5/1068
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Author Notes:Signe T. Andersen, Daniel R. Witte, Else-Marie Dalsgaard, Henning Andersen, Peter Nawroth, Thomas Fleming, Troels M. Jensen, Nanna B. Finnerup, Troels S. Jensen, Torsten Lauritzen, Eva L. Feldman, Brian C. Callaghan, and Morten Charles
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Summary:OBJECTIVE To study incident diabetic polyneuropathy (DPN) prospectively during the first 13 years after a screening-based diagnosis of type 2 diabetes and determine the associated risk factors for the development of DPN. - RESEARCH DESIGN AND METHODS We assessed DPN longitudinally in the Danish arm of the Anglo-Danish-Dutch study of Intensive Treatment of Diabetes in Primary Care (ADDITION) using the Michigan Neuropathy Screening Instrument questionnaire (MNSIQ), defining DPN with scores ≥4. Risk factors present at the diabetes diagnosis associated with the risk of incident DPN were estimated using Cox proportional hazard models adjusted for trial randomization group, sex, and age. - RESULTS Of the total cohort of 1,533 people, 1,445 completed the MNSIQ at baseline and 189 (13.1%) had DPN at baseline. The remaining 1,256 without DPN entered this study (median age 60.8 years [interquartile range 55.6; 65.6], 59% of whom were men). The cumulative incidence of DPN was 10% during 13 years of diabetes. Age (hazard ratio [HR] 1.03 [95% CI 1.00; 1.07]) (unit = 1 year), weight (HR 1.09 [95% CI 1.03; 1.16]) (unit = 5 kg), waist circumference (HR 1.14 [95% CI 1.05; 1.24]) (unit = 5 cm), BMI (HR 1.14 [95% CI 1.06; 1.23]) (unit = 2 kg/m2), log2 methylglyoxal (HR 1.45 [95% CI 1.12; 1.89]) (unit = doubling), HDL cholesterol (HR 0.82 [95% CI 0.69; 0.99]) (unit = 0.25 mmol/L), and LDL cholesterol (HR 0.92 [95% CI 0.86; 0.98]) (unit = 0.25 mmol/L) at baseline were significantly associated with the risk of incident DPN. - CONCLUSIONS This study provides further epidemiological evidence for obesity as a risk factor for DPN. Moreover, low HDL cholesterol levels and higher levels of methylglyoxal, a marker of dicarbonyl stress, are identified as risk factors for the development of DPN.
Item Description:Gesehen am 14.05.2020
Physical Description:Online Resource
ISSN:1935-5548
DOI:10.2337/dc17-2062

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