Peripheral Insensate Neuropathy- Is Height a Risk Factor?

Abstract

Introduction: Peripheral insensate neuropathy is one of the most commonest and the earliest forms of peripheral neuropathy. It is one of the leading causes of the disability in working population who are at risk. Methods:A study was conducted in Kasturba medical college (Manipal university) in the year 2009-12, which included examination of 818 people of more than 30yrs of age by random sampling method who were attending the outpatient clinic. A monofilament was used to determine the peripheral insensate neuropathy, which was defined by the presence of one or more insensate areas. Results:In our study , the prevalence of peripheral insensate neuropathy was 16.2 % ( p-0.0001), among which 9.7% were males and 7.5% were females. The males were 1.27 times significantly at a higher risk than the females , even after a height adjustment to the gender difference in height. As the height increased, the prevalence of peripheral insensate neuropathy increased, irrespective of the diabetic and hypertensive statuses. The risk of the peripheral insensate neuropathy increases at a height of >167 cm in males and at a height of >159 cm in females. Conclusion:The authors conclude that body height is an important and an independent risk factor for peripheral insensate neuropathy, irrespective of co morbidities. Height as a marker, helps the health care professionals in identifying the people who are at risk for peripheral insensate neuropathy.G S Sharath Kote, ajay N Bhat, thajuddeeN K, MohaMMed h ISMaIl, aBhISheK Gupta InTROduCTIOnPeripheral insensate neuropathy is defined as the presence of one or more insensate areas [1]. It is a common problem which is encountered in middle and old aged people. It is one of the disabling complications of diabetes because of its high incidence and its potential to lead to lower extremity ulceration, deformation and amputation [2]. Many factors have been associated with neuropathy, like age, sex, race, glycaemic control, nutrition, toxin exposure, drugs, alcohol, etc [1,3,4].Peripheral neuropathy affects 2-8% of the adults and it increases with age. With an early detection and history taking and focused laboratory tests, the underlying cause can be identified in ~75% of the cases. The prevalence of neuropathy is 66% for type 1 diabetes and it is 59% for type 2 diabetes. In a population cohort of diabetic patients, two third of the diabetics had an objective evidence of neuropathy, mainly a loss of the foot sensation, but only 15% of the IDDM cases and 13% of the NIDDM cases were symptomatic. Peripheral neuropathy can occur before the onset of clinically detectable Diabetes mellitus (DM) [5].Height is an important and a practical predictor of peripheral insensate neuropathy. As the height increases, the lengths of the nerve fibers also increase and so the surface area of the axons is available for the toxin exposure and the physical damage is more. So, the risk of peripheral insensate neuropathy increases with an increase in height. Many studies have shown the corelation of height with p...

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