Metabolic syndrome is related to polyneuropathy and impaired peripheral nerve function: a prospective population-based cohort study

Abstract

Metabolic syndrome, abdominal obesity and dyslipidaemia, are strongly associated with polyneuropathy, irrespective of the presence of diabetes. Metabolic syndrome also associates with impaired nerve function in people without polyneuropathy. Our study therefore suggests that cardiometabolic disturbances have an impact on peripheral nerve function that extends beyond clinically manifest disease.

Diabetes and obesity are the main metabolic drivers of peripheral neuropathy

“…Including this study, five recent investigations reveal that obesity is significantly associated with peripheral neuropathy in multivariable analyses 22, 23, 24, 31. Our results are comparable to those found in 2035 Han Chinese subjects in Shanghai 24.…”

“…This finding was observed although obesity was the only other MetS component significantly associated with peripheral neuropathy. Our finding is comparable to studies performed in China,25 the United States,23 and the Netherlands 31. Unlike the studies in China and Netherlands, we did not include hyperglycemia as one of the MetS components since this is already the strongest and most well‐established risk factor for peripheral neuropathy.…”

“…Participants with prediabetes also have a higher prevalence of peripheral neuropathy, but the association does not meet statistical significance in multivariable models. These results are comparable to findings in other populations including those in the United States,22, 23 another region in China,24, 25 and the Netherlands 31. Now that the evidence supporting these specific metabolic drivers of nerve injury is increasingly robust, efforts should turn to interventional studies aimed at weight loss and/or exercise in populations at high risk of peripheral neuropathy.…”

“…With many previous studies supporting,16, 32, 33 and some not supporting,23, 34 an association of prediabetes with peripheral neuropathy, our results do not push the overall level of evidence much in either direction. Our study is now the third to show an increased OR in those with prediabetes that does not meet statistical significance 22, 31. Possible explanations are that the study was not adequately powered to detect this small effect size or that prediabetes is not the underlying metabolic driver of nerve injury when accounting for other metabolic factors.…”

“…Despite the differences in population location and demographics, the definition of neuropathy, and statistical modeling design, the results are consistent. Similarly, studies in obese and elderly populations in the United States,22, 23 and an older population in the Netherlands31 lead to the same conclusion despite study design differences. With strong evidence supporting obesity as a metabolic driver of peripheral neuropathy, we need to start considering obesity as a potential cause of peripheral neuropathy in the nondiabetic obese and design interventions that address this underlying metabolic cause.…”