Peripheral neuropathy is associated with insulin resistance independent of metabolic syndrome

Han, Ling; Ji, Lijin; Chang, Jing; Wen, Jian Guo; Zhao, Wang; Shi, Hongli; Zhou, Lei; Li, Yiming; Hu, Renming; Hu, Ji; Lü, Bin

doi:10.1186/s13098-015-0010-y

Cited by 49 publications

(41 citation statements)

References 26 publications

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“…This study also demonstrated an independent association of waist circumference with DPN after adjusting for demographics and other metabolic components. Similar results have been demonstrated by two others studies performed in China and Germany (22, 36). Moreover, low physical activity is associated with DPN (22), as patients with T2DM and DPN seem to be less active compared to T2DM subjects without DPN (43).…”

Section: Individual Mets Components and Dpnsupporting

confidence: 92%

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Mediators of diabetic neuropathy: is hyperglycemia the only culprit?

Grisold

Callaghan

Feldman

2017

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of this review Diabetic peripheral neuropathy (DPN) is a disabling, highly prevalent complication of both type 1 and type 2 diabetes mellitus (T1DM, T2DM). Large clinical studies support the concept that, in addition to hyperglycemia, components of the metabolic syndrome (MetS) may underlie the pathogenesis of DPN, especially in T2DM. This review will present the evidence supporting the MetS and its individual components as potential causal factors for the development of neuropathy. Recent findings In addition to poor glycemic control and duration of diabetes, components of MetS such as dyslipidemia, obesity, and hypertension, may have an important impact on the prevalence of DPN. Obesity and prediabetes have the most data to support their role in neuropathy, whereas hypertension and dyslipidemia have more mixed results. Non-metabolic factors, such as genetic susceptibility, age, height, gender, smoking, and alcohol, have also been highlighted as potential risk factors in peripheral neuropathy, although the exact contribution of these factors to DPN remains unknown. Summary DPN is a chronic and disabling disease, and the accurate identification and modification of DPN risk factors is important for clinical management. Recent data support a role for components of the MetS and other risk factors in the development of DPN, offering novel targets beyond hyperglycemia for therapeutic development.

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Section: Individual Mets Components and Dpnsupporting

confidence: 92%

“…The MetS by definition comprises obesity, insulin resistance, hypertension, hypertriglyceridemia, and dyslipidemia, and its coexistence with diabetes has been described to be associated with the development of DPN (25, 32–36). The main findings of the conducted studies are presented in Table 2.…”

Section: The Mets and Dpnmentioning

confidence: 99%

Mediators of diabetic neuropathy: is hyperglycemia the only culprit?

Grisold

Callaghan

Feldman

2017

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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“…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.…”

Section: Discussionsupporting

confidence: 82%

“…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.…”

Section: Discussionsupporting

confidence: 77%

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Diabetes and obesity are the main metabolic drivers of peripheral neuropathy

Callaghan

Gao

Li³

et al. 2018

Ann Clin Transl Neurol

159

110

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ObjectiveTo determine the associations between individual metabolic syndrome (MetS) components and peripheral neuropathy in a large population‐based cohort from Pinggu, China.MethodsA cross‐sectional, randomly selected, population‐based survey of participants from Pinggu, China was performed. Metabolic phenotyping and neuropathy outcomes were performed by trained personnel. Glycemic status was defined according to the American Diabetes Association criteria, and the MetS using modified consensus criteria (body mass index instead of waist circumference). The primary peripheral neuropathy outcome was the Michigan Neuropathy Screening Instrument (MNSI) examination. Secondary outcomes were the MNSI questionnaire and monofilament testing. Multivariable models were used to assess for associations between individual MetS components and peripheral neuropathy. Tree‐based methods were used to construct a classifier for peripheral neuropathy using demographics and MetS components.ResultsThe mean (SD) age of the 4002 participants was 51.6 (11.8) and 51.0% were male; 37.2% of the population had normoglycemia, 44.0% prediabetes, and 18.9% diabetes. The prevalence of peripheral neuropathy increased with worsening glycemic status (3.25% in normoglycemia, 6.29% in prediabetes, and 15.12% in diabetes, P < 0.0001). Diabetes (odds ratio [OR] 2.60, 95% CI 1.77–3.80) and weight (OR 1.09, 95% CI 1.02–1.18) were significantly associated with peripheral neuropathy. Age, diabetes, and weight were the primary splitters in the classification tree for peripheral neuropathy.InterpretationSimilar to previous studies, diabetes and obesity are the main metabolic drivers of peripheral neuropathy. The consistency of these results reinforces the urgent need for effective interventions that target these metabolic factors to prevent and/or treat peripheral neuropathy.

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Hemoglobin, Body Mass Index, and Age as Risk Factors for Paclitaxel- and Oxaliplatin-Induced Peripheral Neuropathy

Mizrahi

Park

et al. 2021

JAMA Netw Open

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IMPORTANCE Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating adverse effect of neurotoxic cancer treatments including taxanes and platinum agents. Limited knowledge exists of potential prechemotherapy factors associated with CIPN development. OBJECTIVE To identify the association of pretreatment blood-based and clinical factors with CIPN persistence in patients who received paclitaxel or oxaliplatin. DESIGN, SETTING, AND PARTICIPANTS This cohort study assessed pretreatment blood-based clinical factors and demographic characteristics of 333 patients treated with paclitaxel and oxaliplatin chemotherapy at urban multicenter cancer clinics and academic institutions in Australia between September 2015 and February 2020. Comprehensive neuropathy assessments were undertaken 3 to 12 months posttreatment. Posttreatment CIPN severity was compared with blood-based factors within 30 days prior to commencing chemotherapy. Data were analyzed between March and December 2020. EXPOSURES Paclitaxel or oxaliplatin chemotherapy. MAIN OUTCOMES AND MEASURES CIPN was measured using composite neurological grading scales, nerve conduction studies, and assessments of fine motor skills (grooved pegboard test), sensory function (grating orientation test and 2-point discrimination), and patient-reported outcomes. Independent samples t tests and Mann-Whitney U tests with post hoc Bonferroni correction were used to compare CIPN between patients according to blood-based factor normative ranges. Linear regression was used to identify blood-based and clinical associations with CIPN development. RESULTS The study included 333 participants (266 [79.9%] women; median [interquartile range] age, 58 [18] years) who were consecutively recruited and referred (228 treated with paclitaxel, 105

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Peripheral neuropathy is associated with insulin resistance independent of metabolic syndrome

Cited by 49 publications

References 26 publications

Mediators of diabetic neuropathy: is hyperglycemia the only culprit?

Mediators of diabetic neuropathy: is hyperglycemia the only culprit?

Diabetes and obesity are the main metabolic drivers of peripheral neuropathy

Hemoglobin, Body Mass Index, and Age as Risk Factors for Paclitaxel- and Oxaliplatin-Induced Peripheral Neuropathy

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