Associations of serum low-density lipoprotein and systolic blood pressure levels with type 2 diabetic patients with and without peripheral neuropathy: Systemic review, meta-analysis and meta-regression analysis of observational studies

Abstract

Background:Compositional abnormalities in lipoproteins and cardiovascular risk factors play an important role in the progression of diabetic peripheral neuropathy (DPN). This systematic review aimed to estimate the predicting value of low-density lipoprotein (LDL) and systolic blood pressure (SBP) level in type-2 diabetes mellitus (T2DM) patients with and without peripheral neuropathy. We also tried to determine whether LDL and SBP are associated with an increased collision risk of DPN. Materials and Methods:A systematic search was conducted for eligible publications which explored the LDL and SBP level in T2DM patients with and without peripheral neuropathy. The quality of the included studies was assessed by the QUADAS-2 tool. The standardized mean difference (SMD) with 95% CI of LDL and SBP level were pooled to assess the correlation between LDL and SBP level with DPN. We performed random effects meta-regression analyses to investigate factors associated with an increased collision risk of DPN. Results:There was a significant association between LDL and SBP with poor prognosis of DPN in those included studies (I2= 88.1% and I2= 84.9%, respectively, Both P < 0.001). European T2DM patients have higher serum level of LDL in compare with the European DPN patients (SMD = 0.16, 95 % CI: -0.06 - 0.38; P <0.001). SBP level was associated with a 2.6-fold decrease in non-DPN patients of T2DM (SMD = -2.63, 95% CI: -4.00 - -1.27, P <0.001). Old age European T2DM patients have significantly high risk for diabetes drivers. Furthermore, the results of the case-control study design model are more precise to show the accuracy of SBP in Asian T2DM patients. Conclusion:Our finding supports the LDL and SBP status could be associated with increased risk of peripheral neuropathy in T2DM patients.

Study on Risk Factors of Peripheral Neuropathy in Type 2 Diabetes Mellitus and Establishment of Prediction Model

“…As shown in the present study, SBP was one of the risk factors for DPN among patients withT2DM, consistent with previous studies. A systematic review showed a 2.6-fold higher SBP in T2DM patients with DPN than in T2DM patients without DPN [9]. Regardless of whether T2DM is accompanied by hypertension, an elevated SBP always increased the risk of DPN [10].…”