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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind41
Udgave nummer5
Sider (fra-til)1068-1075
ISSN0149-5992
DOI
StatusUdgivet - maj 2018
Udgivet eksterntJa

Fingeraftryk

Diabetic Neuropathies
Denmark
Type 2 Diabetes Mellitus
Pyruvaldehyde
HDL Cholesterol
Random Allocation
Proportional Hazards Models
LDL Cholesterol
Primary Health Care
Research Design
Age Groups
Weights and Measures

Citer dette

Andersen, S. T., Witte, D. R., Dalsgaard, E-M., Andersen, H., Nawroth, P., Fleming, T., ... 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
Andersen, Signe T ; Witte, Daniel R ; Dalsgaard, Else-Marie ; Andersen, Henning ; Nawroth, Peter ; Fleming, Thomas ; Jensen, Troels M ; Finnerup, Nanna B ; Jensen, Troels S ; Lauritzen, Torsten ; Feldman, Eva L ; Callaghan, Brian C ; Charles, Morten. / Risk Factors for Incident Diabetic Polyneuropathy in a Cohort With Screen-Detected Type 2 Diabetes Followed for 13 Years : ADDITION-Denmark. I: Diabetes Care. 2018 ; Bind 41, Nr. 5. s. 1068-1075.
@article{1554894f4a0948b1925ce30178537d11,
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 marker of dicarbonyl stress, are identified as risk factors for the development of DPN.",
keywords = "Aged, Cohort Studies, Denmark/epidemiology, Diabetes Mellitus, Type 2/complications, Diabetic Neuropathies/epidemiology, Female, Follow-Up Studies, Humans, Incidence, Male, Mass Screening, Middle Aged, Obesity/complications, Primary Health Care/statistics & numerical data, Risk Factors, Waist Circumference",
author = "Andersen, {Signe T} and Witte, {Daniel R} and Else-Marie Dalsgaard 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",
note = "{\circledC} 2018 by the American Diabetes Association.",
year = "2018",
month = "5",
doi = "10.2337/dc17-2062",
language = "English",
volume = "41",
pages = "1068--1075",
journal = "Diabetes Care",
issn = "0149-5992",
publisher = "American Diabetes Association",
number = "5",

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Andersen, ST, Witte, DR, Dalsgaard, E-M, 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; Andersen, Henning; Nawroth, Peter; Fleming, Thomas; Jensen, Troels M; Finnerup, Nanna B; Jensen, Troels S; Lauritzen, Torsten; Feldman, Eva L; Callaghan, Brian C; Charles, Morten.

I: Diabetes Care, Bind 41, Nr. 5, 05.2018, s. 1068-1075.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer 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

N1 - © 2018 by the American Diabetes Association.

PY - 2018/5

Y1 - 2018/5

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 marker of dicarbonyl stress, are identified as risk factors for the development of DPN.

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 marker of dicarbonyl stress, are identified as risk factors for the development of DPN.

KW - Aged

KW - Cohort Studies

KW - Denmark/epidemiology

KW - Diabetes Mellitus, Type 2/complications

KW - Diabetic Neuropathies/epidemiology

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Mass Screening

KW - Middle Aged

KW - Obesity/complications

KW - Primary Health Care/statistics & numerical data

KW - Risk Factors

KW - Waist Circumference

U2 - 10.2337/dc17-2062

DO - 10.2337/dc17-2062

M3 - Journal article

VL - 41

SP - 1068

EP - 1075

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 5

ER -