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Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status.

Abstract：

OBJECTIVE:Previous studies demonstrate that the metabolic syndrome is associated with distal symmetric polyneuropathy (DSP). We aimed to determine the magnitude of this effect and the precise components involved. RESEARCH DESIGN AND METHODS:We determined the symptomatic DSP prevalence in the Health, Aging, and Body Composition (Health ABC) study (prospective cohort study, with subjects aged 70-79 years at baseline), stratified by glycemic status (glucose tolerance test) and the number of additional metabolic syndrome components (updated National Cholesterol Education Program/Adult Treatment Panel III definition). DSP was defined as neuropathic symptoms (questionnaire) plus at least one of three confirmatory tests (heavy monofilament, peroneal conduction velocity, and vibration threshold). Multivariable logistic and linear regression evaluated the association of metabolic syndrome components with DSP in cross-sectional and longitudinal analyses. RESULTS:Of 2,382 participants with neuropathy measures (mean age 73.5 ± 2.9 years, 38.2% black, 51.7% women), 21.0% had diabetes, 29.9% prediabetes, 52.8% metabolic syndrome, and 11.1% DSP. Stratified by glycemic status, DSP prevalence increased as the number of metabolic syndrome components increased (P = 0.03). Diabetes (cross-sectional model, odds ratio [OR] 1.65 [95% CI 1.18-2.31]) and baseline hemoglobin A1C (longitudinal model, OR 1.42 [95% CI 1.15-1.75]) were the only metabolic syndrome measures significantly associated with DSP. Waist circumference and HDL were significantly associated with multiple secondary neuropathy outcomes. CONCLUSIONS:Independent of glycemic status, symptomatic DSP is more common in those with additional metabolic syndrome components. However, the issue of which metabolic syndrome components drive this association, in addition to hyperglycemia, remains unclear. Larger waist circumference and low HDL may be associated with DSP, but larger studies with more precise metabolic measures are needed.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Callaghan BC,Xia R,Banerjee M,de Rekeneire N,Harris TB,Newman AB,Satterfield S,Schwartz AV,Vinik AI,Feldman EL,Strotmeyer ES,Health ABC Study.

doi

10.2337/dc16-0081

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

801-7

issue

eissn

0149-5992

issn

1935-5548

pii

dc16-0081

journal_volume

pub_type

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Metabolic Syndrome Components Are Associated With Symptomatic Polyneuropathy Independent of Glycemic Status.