Insulin resistance is independently associated with peripheral and autonomic neuropathy in Korean type 2 diabetic patients.
In addition to chronic hyperglycemia, insulin resistance itself has been proposed to cause a diabetic neuropathy. We evaluated the role of insulin resistance in the pathogenesis of peripheral and autonomic neuropathy in patients with type 2 diabetes. Eighty-six patients with type 2 diabetes were evaluated for the anthropometric and biochemical profiles, and Kitt value was calculated from insulin tolerance test to assess the insulin resistance. Various autonomic function tests, nerve conduction velocity, and quantitative sensory tests were performed to assess autonomic and peripheral neuropathy. In univariate analysis, both autonomic and peripheral neuropathy were significantly associated with glycemic exposure index (GE index), HDL-cholesterol, duration of DM, and Kitt value. In stepwise linear regression analysis, GE index was an independent predictor of autonomic and peripheral neuropathy (β = 0.643, P < 0.001; β = 0.207, P = 0.013, respectively), and Kitt value was also an independent factor for the autonomic and peripheral neuropathy (β = - 0.306, P < 0.001; β = - 0.329, P < 0.001, respectively). Low HDL-cholesterol increased the odds ratio for peripheral neuropathy. Insulin resistance is independently associated with peripheral and autonomic neuropathy in Korean Type 2 diabetic patients along with hyperglycemia and HDL-cholesterol.
Department of Neurology, Yonsei University College of Medicine, Gangnam-Gu, Seoul, Korea.
Kee Ook
KO
Lee
Ji Sun
JS
Nam
Chul Woo
CW
Ahn
Ji-Man
JM
Hong
Seung-Min
SM
Kim
Il-Nam
IN
Sunwoo
Joon-Shik
JS
Moon
Sang-Jun
SJ
Na
Young-Chul
YC
Choi
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000209:etiology / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism; D003929:Diabetic Neuropathies / Q000209:etiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D055815:Young Adult