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

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; Morten Charles

doi:10.2337/dc17-2062

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

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, Morten Charles

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

155 Citationer (Scopus)

Abstract

Tidligere studier af type 2-diabetes viser, at op mod hver anden eller tredje person med diabetes udvikler polyneuropati i løbet af de første 10 år. Polyneuropati kan ikke behandles og forbindes med både højere sygelighed og dødelighed. Dette studie viser en langt mindre udvikling af diabetisk polyneuropati end set i tidligere studier af type 2-diabetes: kun 10% af deltagerne udviklede polyneuropati i løbet af 13 års opfølgning. Studiet bygger på data for 1256 personer med screeningsopdaget type 2 diabetes, som blev fulgt i almen praksis. Risikoen for at udvikle polyneuropati var større for de personer, der ved diagnosetidspunktet var overvægtige (ud fra vægt, BMI og taljemål), havde lavere værdier af HDL-cholesterol og højere værdier af methylglyoxal (en markør for dicarbonyl stress). Studiet viser, at tidlig opsporing og behandling af diabetes formentlig har en positiv effekt på udviklingen af polyneuropati. Desuden indikerer studiet, at der bør være ekstra fokus på optimal behandling af overvægtige personer med diabetes for yderligere at reducere risikoen for at udvikle polyneuropati.

Originalsprog	Engelsk
Tidsskrift	Diabetes Care
Vol/bind	41
Nummer	5
Sider (fra-til)	1068-1075
Antal sider	8
ISSN	0149-5992
DOI	https://doi.org/10.2337/dc17-2062
Status	Udgivet - 1 maj 2018

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Andersen, S. T., Witte, D. R., Dalsgaard, E. M., Andersen, H., Nawroth, P., Fleming, T., Jensen, T. M., Finnerup, N. B., Jensen, T. S., Lauritzen, T., Feldman, E. L., Callaghan, B. C., & Charles, M. (2018). Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years: Addition-Denmark. Diabetes Care, 41(5), 1068-1075. https://doi.org/10.2337/dc17-2062

@article{d2b4e14093e64c73be5bd1f2b7154c6e,

title = "Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years: Addition-Denmark",

abstract = "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 markerofdicarbonyl stress, are identifiedasrisk factors for the developmentofDPN.",

author = "Andersen, {Signe T.} and Witte, {Daniel R.} and Dalsgaard, {Else Marie} and Henning Andersen and Peter Nawroth and Thomas Fleming and Jensen, {Troels M.} and Finnerup, {Nanna B.} and Jensen, {Troels S.} and Torsten Lauritzen and Feldman, {Eva L.} and Callaghan, {Brian C.} and Morten Charles",

year = "2018",

month = may,

day = "1",

doi = "10.2337/dc17-2062",

language = "English",

volume = "41",

pages = "1068--1075",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

number = "5",

}

Andersen, ST , Witte, DR, Dalsgaard, EM, Andersen, H, Nawroth, P, Fleming, T, Jensen, TM, Finnerup, NB , Jensen, TS , Lauritzen, T, Feldman, EL, Callaghan, BC & Charles, M 2018, 'Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years: Addition-Denmark', Diabetes Care, bind 41, nr. 5, s. 1068-1075. https://doi.org/10.2337/dc17-2062

Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years: Addition-Denmark. / Andersen, Signe T.; Witte, Daniel R.; Dalsgaard, Else Marie et al.
I: Diabetes Care, Bind 41, Nr. 5, 01.05.2018, s. 1068-1075.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Risk factors for incident diabetic polyneuropathy in a cohort with screen-detected type 2 diabetes followed for 13 years

T2 - Addition-Denmark

AU - Andersen, Signe T.

AU - Witte, Daniel R.

AU - Dalsgaard, Else Marie

AU - Andersen, Henning

AU - Nawroth, Peter

AU - Fleming, Thomas

AU - Jensen, Troels M.

AU - Finnerup, Nanna B.

AU - Jensen, Troels S.

AU - Lauritzen, Torsten

AU - Feldman, Eva L.

AU - Callaghan, Brian C.

AU - Charles, Morten

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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 markerofdicarbonyl stress, are identifiedasrisk factors for the developmentofDPN.

AB - 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 markerofdicarbonyl stress, are identifiedasrisk factors for the developmentofDPN.

UR - http://www.scopus.com/inward/record.url?scp=85046123855&partnerID=8YFLogxK

U2 - 10.2337/dc17-2062

DO - 10.2337/dc17-2062

M3 - Journal article

C2 - 29487078

AN - SCOPUS:85046123855

SN - 0149-5992

VL - 41

SP - 1068

EP - 1075

JO - Diabetes Care

JF - Diabetes Care

IS - 5

ER -

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

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