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

Research output: Contribution to journalJournal articleResearchpeer-review

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.

Original languageEnglish
JournalDiabetes Care
Volume41
Issue number5
Pages (from-to)1068-1075
ISSN0149-5992
DOIs
Publication statusPublished - May 2018
Externally publishedYes

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

Fingerprint Dive into the research topics of 'Risk Factors for Incident Diabetic Polyneuropathy in a Cohort With Screen-Detected Type 2 Diabetes Followed for 13 Years: ADDITION-Denmark'. Together they form a unique fingerprint.

  • Cite this

    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