Determination of peripheral neuropathy prevalence and associated factors in Chinese subjects with diabetes and pre-diabetes - ShangHai Diabetic neuRopathy Epidemiology and Molecular Genetics Study (SH-DREAMS)

PLoS One. 2013 Apr 16;8(4):e61053. doi: 10.1371/journal.pone.0061053. Print 2013.

Abstract

Objective: This study determined the prevalence and factors associated with peripheral neuropathy (PN) in subjects with diabetes mellitus, impaired glucose regulation (IGR), and normal glucose tolerance (NGT) in a community-based Chinese population.

Research design and methods: A total of 2035 subjects in Shanghai were classified as having NGT, IGR, or diabetes. All subjects underwent complete foot examination. PN was assessed according to the neuropathy symptom and neuropathy disability scores. Binary logistic regression was performed to analyze the contributions of factors to PN.

Results: The prevalence of PN was 8.4%, 2.8%, and 1.5% in diabetes mellitus, IGR, and NGT subjects, respectively (P<0.05 for diabetes vs. NGT, and IGR). The subjects with known diabetes had the highest frequency of PN (13.1%). Among the subjects without diabetes, those with PN were older, had a higher waist circumference and 2-h postprandial plasma glucose levels, and were more likely to be hypertensive. Among the IGR subjects, other than age, the 2-h postprandial plasma glucose level was an independent factor significantly associated with PN. Meanwhile, among the subjects with diabetes, PN was associated with fasting plasma glucose, duration of diabetes, and decreased estimated glomerular filtration rate.

Conclusions: The prevalence of PN is slightly higher in individuals with IGR than that in individuals with NGT, but small fibre damage in IGR as the earliest nerve fibre deficit may be underestimated in our study. As an independent risk factor, postprandial plasma glucose level may be an important target for strategies to prevent or improve PN in IGR subjects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose / metabolism
  • China / epidemiology
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetic Neuropathies / blood
  • Diabetic Neuropathies / epidemiology*
  • Female
  • Glomerular Filtration Rate / physiology
  • Glucose Intolerance / blood
  • Glucose Intolerance / epidemiology
  • Humans
  • Insulin Resistance / physiology
  • Male
  • Peripheral Nervous System Diseases / blood
  • Peripheral Nervous System Diseases / epidemiology*
  • Prediabetic State / blood
  • Prediabetic State / epidemiology*
  • Prevalence

Substances

  • Blood Glucose

Grant support

This study was supported by grants to from the National Natural Science Foundation of China (30900501, to BL), Ministry of Education of the People’s Republic of China (20090071120042, to BL), Fudan Zhuoxue Project (to BL), 985 Project (985III-YFX0302, to YML) and Shanghai Key Medical Disciplines Construction Funds (ZK2012A19). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.