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Increased aortic stiffness predicts future development and progression of peripheral neuropathy in patients with type 2 diabetes: the Rio de Janeiro Type 2 Diabetes Cohort Study

Cardoso, Claudia R. L. ; Moran, Camila B. M. ; Marinho, Fernanda S. ; Ferreira, Marcel T. ; Salles, Gil F.

Diabetologia, 2015-09, Vol.58 (9), p.2161-2168 [Periódico revisado por pares]

Berlin/Heidelberg: Springer Berlin Heidelberg

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Título:
Increased aortic stiffness predicts future development and progression of peripheral neuropathy in patients with type 2 diabetes: the Rio de Janeiro Type 2 Diabetes Cohort Study
Autor: Cardoso, Claudia R. L. ; Moran, Camila B. M. ; Marinho, Fernanda S. ; Ferreira, Marcel T. ; Salles, Gil F.
Assuntos: Adult ; Aged ; Aged, 80 and over ; Aorta - pathology ; Arteries - pathology ; Cohort analysis ; Diabetes ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - pathology ; Diabetic Neuropathies - blood ; Diabetic Neuropathies - pathology ; Disease Progression ; Female ; Follow-Up Studies ; Hospitals ; Human Physiology ; Humans ; Hyperglycemia ; Hypertension ; Hypertension - pathology ; Internal Medicine ; Male ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Metabolism ; Microcirculation ; Middle Aged ; Multivariate Analysis ; Peripheral Nervous System Diseases - pathology ; Peripheral neuropathy ; Poisson Distribution ; Prognosis ; Prospective Studies ; Pulse Wave Analysis ; Risk factors ; Vascular Stiffness
É parte de: Diabetologia, 2015-09, Vol.58 (9), p.2161-2168
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: Aims/hypothesis Diabetic peripheral neuropathy (DPN) is a chronic microvascular complication that is strongly associated with poor glycaemic control and also with a worse prognosis. We aimed to evaluate the predictors of the development and progression of DPN in a cohort of high-risk patients with type 2 diabetes. Methods In a prospective study, 477 patients with type 2 diabetes were clinically assessed for the presence of DPN at baseline and after a median follow-up of 6.2 years (range 2–10 years). Clinical laboratory data were obtained at study entry and throughout the follow-up. Aortic stiffness was assessed by the carotid–femoral pulse wave velocity (cf-PWV) at baseline. Multivariate Poisson regression analysis was used to examine independent predictors of the development/progression of DPN. Results At baseline, 135 patients (28%) had DPN, and during follow-up 97 patients (20%) had either a new development or a worsening of DPN. Patients who showed a development or progression of DPN were taller and had a longer duration of diabetes, a greater prevalence of other microvascular complications and hypertension, greater aortic stiffness and poorer glycaemic control than patients who did not have new or progressive neuropathy. After adjustments for the baseline prevalence of DPN, the patient’s age and sex, and the time interval between DPN assessments; an increased aortic stiffness (cf-PWV >10 m/s) were predictive of new/progressive DPN (incidence rate ratio 2.04, 95% CI 1.28, 3.23; p = 0.002). Other independent predictors were the mean first-year HbA 1c level ( p = 0.05), nephropathy ( p = 0.006), arterial hypertension ( p = 0.06) and height ( p = 0.03). Conclusions/interpretation Increased aortic stiffness at baseline predicts the future development or progression of peripheral neuropathy, independent of diabetic metabolic control, suggesting a physiopathological link between macrovascular and microvascular abnormalities in type 2 diabetes.
Editor: Berlin/Heidelberg: Springer Berlin Heidelberg
Idioma: Inglês

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Increased aortic stiffness predicts future development and progression of peripheral neuropathy in patients with type 2 diabetes: the Rio de Janeiro Type 2 Diabetes Cohort Study

Cardoso, Claudia R. L. ; Moran, Camila B. M. ; Marinho, Fernanda S. ; Ferreira, Marcel T. ; Salles, Gil F.

Berlin/Heidelberg: Springer Berlin Heidelberg

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