title: Risk factors and pain status due to diabetic neuropathy in chronic long-term diabetic patients in a Chinese urban population.
abstract: BACKGROUND
  With economic growth and urbanization there have been significant changes in the life style and diet of urban residents in large cities of China, which is experiencing a rapid increase in the prevalence of diabetes. While high prevalence of diabetes has been reported, little is known of the long-term effects of diabetes in such a large population. The aim of this study was to estimate the morbidity rate of diabetic peripheral neuropathy (DPN) in a Chinese urban diabetic population with more than 10 years' disease duration, and evaluate the relevant risk factors. The clinical manifestation of DPN and pain status was also assessed.
  
  
  METHODS
  Five hundred and sixty-five diabetes patients were recruited into the study. Symptoms and examination helped diagnose neuropathy. The clinical manifestation of DPN was assessed with a visual analog pain score (VAS). Diabetic complication status was determined from medical records. Serum lipids and lipoproteins, glycosylated hemoglobin (HbA1c), and the urinary albumin excretion rate were measured.
  
  
  RESULTS
  The morbidity rate of DPN was 46.6%. HbA1c, hyperlipidemia, and retinopathy were significantly associated with neuropathy, and these risk factors were correlated with other diabetic micro and/or macrovascular complications. The average VAS pain score of the DPN patients was 4.12 ± 2.07. Severe and moderate pain was experienced by 11.4% and 40.5% respectively of DPN patients. About 3.7% of diabetic subjects had lower limb ulcer or amputation.
  
  
  CONCLUSIONS
  The morbidity rate of DPN for diabetic patients with > 10 years duration is very high compared to the range reported for other populations in the world. The risk factors for DPN include HbA1c, hyperlipidemia, and retinopathy. In long-standing diabetic patients, DPN was not associated with diabetic duration, and half of the DPN patients experienced considerable daily suffering.
authors.affiliation: Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
authors.forename: Na
authors.initials: N
authors.lastname: Ji
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
authors.forename: Zhan-Jie
authors.initials: ZJ
authors.lastname: Ren
authors.forename: Ke-Bao
authors.initials: KB
authors.lastname: Jia
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Jia-Xiang
authors.initials: JX
authors.lastname: Ni
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
mesh_terms: D000368:Aged; D002681:China; D003929:Diabetic Neuropathies / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D012307:Risk Factors; D014505:Urban Population
chemical_list: D006442:Glycated Hemoglobin