title: Pulse pressure is independently associated with sensorimotor peripheral neuropathy in patients with type 2 diabetes.
abstract: OBJECTIVE
  The mechanisms responsible for the onset and progression of sensorimotor peripheral neuropathy (SMPN) in type 2 diabetes remain largely unknown. Although a link between hypertension and SMPN has been observed, it is not clear which blood pressure (BP) component (i.e. systolic, SBP; diastolic, DBP; or pulse pressure, PP) is primarily involved. We sought to determine the relationship between BP components and parameters of nerve function in type 2 diabetes.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Academic medical centre.
  
  
  METHODS
  A total of 55 consecutive ambulatory patients with type 2 diabetes (age 62.6 +/-8.0 years, mean +/- SD).
  
  
  METHODS
  Measurement of clinic BP and 10 neurophysiological parameters: motor nerve conduction velocity (NCV; median, ulnar, posterior tibial and peroneal nerve), sensory amplitude (AMP) and latency (LAT; median, ulnar and sural nerve).
  
  
  RESULTS
  Univariate analysis showed that age, diabetes duration, SBP and PP were negatively correlated with nerve function. Regression analysis showed that, after correcting for age, duration of diabetes, glycated haemoglobin, body mass index, microalbuminuria and SBP, PP was independently and negatively associated with NCV (median, P =0.011; ulnar, P = 0.001; peroneal, P = 0.006 and posterior tibial, P = 0.005) and signal AMP (ulnar, P = 0.027; sural, P = 0.055), and positively associated with signal LAT (median, P = 0.083; sural, P = 0.021). SBP was negatively associated with signal AMP (median, P = 0.012) and positively associated with LAT (ulnar, P = 0.018). By contrast, DBP failed to show any significant correlation with nerve function.
  
  
  CONCLUSIONS
  The PP is strongly associated with neurophysiological parameters of nerve function in patients with type 2 diabetes. This relationship is independent of traditional risk factors and other BP components.
authors.affiliation: Department of Internal Medicine, Policlinico IRCCS, Ospedale Maggiore, University of Milan, Milan, Italy.
authors.forename: E A
authors.initials: EA
authors.lastname: Jarmuzewska
authors.forename: A A
authors.initials: AA
authors.lastname: Mangoni
mesh_terms: D000367:Age Factors; D000704:Analysis of Variance; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology*; D010543:Peroneal Nerve / Q000503:physiopathology; D013497:Sural Nerve / Q000503:physiopathology; D013979:Tibial Nerve / Q000503:physiopathology; D014459:Ulnar Nerve / Q000503:physiopathology