PMID- 28893495 OWN - NLM STAT- MEDLINE DCOM- 20180606 LR - 20220316 IS - 1873-460X (Electronic) IS - 1056-8727 (Linking) VI - 31 IP - 11 DP - 2017 Nov TI - The association between pulse wave velocity and peripheral neuropathy in patients with type 2 diabetes mellitus. PG - 1624-1629 LID - S1056-8727(17)30517-2 [pii] LID - 10.1016/j.jdiacomp.2017.07.010 [doi] AB - AIMS: Diabetic peripheral neuropathy (DPN) is the most common diabetic complication, affecting up to half of the patients with type 2 diabetes mellitus (T2DM). Increased aortic stiffness, measured with the carotid-femoral pulse wave velocity (PWV), has been associated with incidence of cardiovascular disease independently of traditional risk factors. Previous data showed associations between risk factors for macroangiopathy and DPN in diabetes. However, the association between PWV and DPN is not well known. In this study we examined the association between PWV and presence as well as severity of DPN in subjects with T2DM. MATERIAL AND METHODS: A total of 381 patients with T2DM were recruited. Participants were classified as having DPN and not having DPN. PWV was measured at the carotid-femoral segment with a non-invasive method using applanation tonometry. DPN was assessed by determination of the Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS). RESULTS: A hundred and seven participants (28.1%) had DPN. Patients with DPN were significantly more often male and older, had longer diabetes duration, higher height, larger waist circumference, higher systolic arterial blood pressure (SBP) and higher PWV (all P<0.05). Furthermore, participants with DPN were treated more often with statins and had lower low density lipoprotein cholesterol; in addition, they were treated more often with antiplatelets, b-blockers and insulin than those without DPN. Univariative logistic regression analysis demonstrated that presence of DPN was significantly associated with age, male gender, longer diabetes duration, height, waist circumference, SBP, PWV, dyslipidemia, HbA1c, retinopathy, nephropathy and peripheral arterial disease. Multivariate logistic regression analysis, after adjustment for age, gender, waist circumference, SBP, nephropathy and use of b-blockers, demonstrated that the odds [OR (95% confidence intervals)] of peripheral neuropathy were associated significantly and independently only with diabetes duration [1.044 (1.009-1.081), P=0.013], height [1.075 (1.041-1.110), P<0.001], HbA1c [1.468 (1.164-1.851), P<0.001], PWV [1.174 (1.054-1.309), P=0.004], dyslipidemia [1.941 (1.015-3.713), P=0.045], retinopathy [4.426 (2.217-8.837), P<0.001] and peripheral arterial disease [4.658 (2.264-9.584), P<0.001]. In addition, multivariate linear regression analysis, after controlling for age, gender, diabetes duration, SBP, HbA1c and nephropathy, demonstrated that an increased NDS was significantly and independently associated with height [standardized regression coefficient (beta=0.229, P<0.001)], PWV (beta=0.197, P<0.001), retinopathy (beta=0.268, P<0.001) and peripheral arterial disease (beta=0.374, P<0.001). CONCLUSION: Increased PWV is associated strongly and independently not only with the presence but also with the severity of DPN in patients with T2DM, irrespective of known risk factors. CI - Copyright (c) 2017 Elsevier Inc. All rights reserved. FAU - Tentolouris, Anastasios AU - Tentolouris A AD - Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. FAU - Eleftheriadou, Ioanna AU - Eleftheriadou I AD - Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. FAU - Grigoropoulou, Pinelopi AU - Grigoropoulou P AD - Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. FAU - Kokkinos, Alexander AU - Kokkinos A AD - Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. FAU - Siasos, Gerasimos AU - Siasos G AD - Department of Cardiology, Hippokration General Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece. FAU - Ntanasis-Stathopoulos, Ioannis AU - Ntanasis-Stathopoulos I AD - Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. FAU - Tentolouris, Nikolaos AU - Tentolouris N AD - Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece. Electronic address: ntentol@med.uoa.gr. LA - eng PT - Journal Article PT - Observational Study DEP - 20170727 PL - United States TA - J Diabetes Complications JT - Journal of diabetes and its complications JID - 9204583 SB - IM MH - Age Factors MH - Aged MH - Cohort Studies MH - Cross-Sectional Studies MH - Diabetes Mellitus, Type 2/*complications MH - Diabetic Angiopathies/complications/*diagnosis/epidemiology/physiopathology MH - Diabetic Neuropathies/*complications/physiopathology MH - Early Diagnosis MH - Female MH - Greece/epidemiology MH - Hospitals, Teaching MH - Humans MH - Male MH - Microvessels/*physiopathology MH - Middle Aged MH - Peripheral Nervous System/*physiopathology MH - Peripheral Vascular Diseases/complications/*diagnosis/epidemiology/physiopathology MH - Pulse Wave Analysis MH - Risk Factors MH - Severity of Illness Index MH - Sex Factors MH - Vascular Stiffness OTO - NOTNLM OT - Arterial stiffness OT - Microvascular complication OT - Peripheral neuropathy OT - Pulse wave velocity OT - Type 2 diabetes mellitus EDAT- 2017/09/13 06:00 MHDA- 2018/06/07 06:00 CRDT- 2017/09/13 06:00 PHST- 2017/04/07 00:00 [received] PHST- 2017/06/08 00:00 [revised] PHST- 2017/07/23 00:00 [accepted] PHST- 2017/09/13 06:00 [pubmed] PHST- 2018/06/07 06:00 [medline] PHST- 2017/09/13 06:00 [entrez] AID - S1056-8727(17)30517-2 [pii] AID - 10.1016/j.jdiacomp.2017.07.010 [doi] PST - ppublish SO - J Diabetes Complications. 2017 Nov;31(11):1624-1629. doi: 10.1016/j.jdiacomp.2017.07.010. Epub 2017 Jul 27.