Diabetic neuropathy is closely associated with arterial stiffening and thickness in Type 2 diabetes.
OBJECTIVE
Interaction of vascular and metabolic factors appears to contribute to the pathogenesis of diabetic neuropathy. The aim of the study was to assess the impact of arterial stiffening and thickness on diabetic neuropathy in Type 2 diabetes.


METHODS
In 294 patients with Type 2 diabetes, neuropathy was assessed by four components: the presence of neuropathic symptoms, the absence of ankle tendon reflexes, perception of vibration scores and heart rate variation. We measured intima-media thickness (IMT) of carotid arteries to assess arterial thickening, and brachial-ankle pulse-wave velocity (PWV) and brachial pulse pressure (PP) which reflect arterial stiffening.


RESULTS
Diabetic neuropathy, defined as > or = two of the four components, was significantly associated with age, duration, glycated haemoglobin (HbA(1c)), systolic blood pressure, diastolic blood pressure, PP, hypertension, retinopathy, urinary albumin excretion rate, nephropathy stages, PWV and IMT. PWV and PP were significantly associated with neuropathy independent of conventional cardiovascular risk factors. Multiple logistic regression analysis revealed that PWV, retinopathy, age, and HbA(1c), were significant independent determinants of neuropathy.


CONCLUSIONS
The present cross-sectional study indicates that markers for vascular wall properties such as PWV, IMT and PP are significantly associated with diabetic neuropathy. PWV and PP are significant determinants of neuropathy independent of conventional cardiovascular risk factors. Multifactorial intervention to inhibit progression of the atherosclerotic process may slow progression of neuropathy.
Yokoyama
H
H
Jiyugaoka Medical Clinic, Internal Medicine, Jiyugaoka, Obihiro, Japan. hiroki@m2.octv.ne.jp
Yokota
Y
Y
Tada
J
J
Kanno
S
S
D000368:Aged; D000419:Albuminuria / Q000503:physiopathology; D001161:Arteriosclerosis / Q000209:etiology / Q000503:physiopathology*; D001783:Blood Flow Velocity; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography