Comparison of diabetic and idiopathic sensory polyneuropathies with respect to nerve fibre affection and risk factors

TY - JOUR

T1 - Comparison of diabetic and idiopathic sensory polyneuropathies with respect to nerve fibre affection and risk factors

AU - Itani, Mustapha

AU - Gylfadottir, Sif

AU - Krøigård, Thomas

AU - Gaist, Laura

AU - Holbech, Jakob Vormstrup

AU - Kristensen, Alexander Gramm

AU - Karlsson, Pall

AU - Möller, Sören

AU - Tankisi, Hatice

AU - Gaist, David

AU - Jensen, Troels S

AU - Finnerup, Nanna Brix

AU - Sindrup, Søren Hein

PY - 2022/3/14

Y1 - 2022/3/14

N2 - Background and purpose: Chronic distal sensory or sensorimotor polyneuropathy is the most common pattern of polyneuropathy. The cause of this pattern is most often diabetes or unknown. This cross-sectional study is one of the first studies to compare the demographics, cardiovascular risk factors and clinical characteristics of diabetic polyneuropathy (DPN) with idiopathic polyneuropathy (IPN).Methods: Patients with DPN were included from a sample of 389 patients with type 2 diabetes mellitus (T2DM) enrolled from a national cohort of patients with recently diagnosed T2DM (Danish Centre for Strategic Research in Type 2 Diabetes cohort). Patients with IPN were included from a regional cohort of patients with symptoms of polyneuropathy referred for workup at a combined secondary and tertiary neurological centre (database cohort).Results: A total of 214 patients with DPN were compared with a total of 88 patients with IPN. Patients with DPN were older (67.4 vs 59 years) and had a longer duration of neuropathy symptoms. Patients with DPN had greater body mass index (32 vs 27.4 kg/m 2) and waist circumference (110 cm vs 97 cm); higher frequency of hypertension diagnosis (72.9% vs 30.7%); lower total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels; and a higher prevalence of use of statins (81.8% vs 19.3%). DPN was associated with a slightly higher autonomic score and total score on the Neuropathy Symptom Score; lower frequency of hyperalgesia, allodynia and decreased vibration on quantitative sensory testing; lower intraepidermal nerve fibre density count and higher frequency of small-fibre neuropathy. Conclusion: DPN and IPN showed clear differences in neuropathy characteristics, indicating that these two entities are to be regarded as aetiologically and pathogenetically distinct.

AB - Background and purpose: Chronic distal sensory or sensorimotor polyneuropathy is the most common pattern of polyneuropathy. The cause of this pattern is most often diabetes or unknown. This cross-sectional study is one of the first studies to compare the demographics, cardiovascular risk factors and clinical characteristics of diabetic polyneuropathy (DPN) with idiopathic polyneuropathy (IPN).Methods: Patients with DPN were included from a sample of 389 patients with type 2 diabetes mellitus (T2DM) enrolled from a national cohort of patients with recently diagnosed T2DM (Danish Centre for Strategic Research in Type 2 Diabetes cohort). Patients with IPN were included from a regional cohort of patients with symptoms of polyneuropathy referred for workup at a combined secondary and tertiary neurological centre (database cohort).Results: A total of 214 patients with DPN were compared with a total of 88 patients with IPN. Patients with DPN were older (67.4 vs 59 years) and had a longer duration of neuropathy symptoms. Patients with DPN had greater body mass index (32 vs 27.4 kg/m 2) and waist circumference (110 cm vs 97 cm); higher frequency of hypertension diagnosis (72.9% vs 30.7%); lower total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol levels; and a higher prevalence of use of statins (81.8% vs 19.3%). DPN was associated with a slightly higher autonomic score and total score on the Neuropathy Symptom Score; lower frequency of hyperalgesia, allodynia and decreased vibration on quantitative sensory testing; lower intraepidermal nerve fibre density count and higher frequency of small-fibre neuropathy. Conclusion: DPN and IPN showed clear differences in neuropathy characteristics, indicating that these two entities are to be regarded as aetiologically and pathogenetically distinct.

KW - diabetes

KW - diabetic neuropathy

KW - neuropathy

KW - neurophysiol, clinicaL

UR - http://www.scopus.com/inward/record.url?scp=85127456137&partnerID=8YFLogxK

U2 - 10.1136/bmjno-2021-000247

DO - 10.1136/bmjno-2021-000247

M3 - Journal article

C2 - 35360409

SN - 2632-6140

VL - 4

JO - BMJ Neurology Open

JF - BMJ Neurology Open

IS - 1

M1 - e000247

ER -