Diabetic Peripheral Neuropathy Associated with Cardiovascular Risk Factors and Glucagon-Like Peptide-1 Concentrations Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus

Abstract

Purpose

This study was aimed at the prevalence, cardiovascular risk factors of diabetic peripheral neuropathy (DPN), and the relationship between DPN and fasting glucagon-like peptide-1 (fGLP-1) concentrations in newly diagnosed patients with type 2 diabetes mellitus (nT2D).

Methods

A cross-sectional descriptive study was conducted from 2015 to 2020 with a population of 473 nT2D. Screening for DPN was based on the United Kingdom screening test. fGLP-1 was measured by enzyme-linked immunosorbent assay.

Results

The prevalence of DPN was 26.6%, in which mild grade was 17.3%, moderate grade was 8.2% and severe grade was 1.1% in total. Age (OR = 1.73, 95% CI 1.12–2.67, p = 0.012), smoking (OR = 1.64, 95% CI 1.03–2.62, p = 0.037), poor control HbA1c (OR = 2.66, 95% CI 1.23–5.76, p = 0.01), 24-h urinary albumin (24hUA) (OR = 2.49, 95% CI 1.26–4.94, p = 0.007), and diabetic retinopathy (OR = 3.17, 95% CI 1.46–6.89, p = 0.002) significantly increased the risk for DPN. In multivariate logistic regression analysis, hypertension (OR = 2.96, 95% CI 1.16–7.55, p = 0.023), triglyceride (OR = 1.50, 95% CI 1.11–2.03, p = 0.009), albumin (OR = 0.85, 95% CI 0.75–0.95, p = 0.005), and fGLP-1 (OR = 0.79, 95% CI 0.67–0.93, p = 0.005) correlated with DPN. The fGLP-1 concentrations were reduced significantly in DPN (p < 0.001). In particular, male patients with DPN had a significantly lower fGLP-1 levels than those without DPN (p < 0.001).

Conclusion

The prevalence of DPN among nT2D was 26.6%. Age, smoking, hypertension, HbA1c control, triglyceride, albumin, 24hUA, diabetic retinopathy were the associated risk factors of DPN, and fGLP-1 was negatively correlated with DPN (OR = 0.79, 95% CI 0.67–0.93, p = 0.005).

Keywords:

• newly diagnosed type 2 diabetes mellitus
• diabetic peripheral neuropathy
• cardiovascular risk factors
• glucagon-like peptide-1 concentrations

Abbreviations

DPN, diabetic peripheral neuropathy; fGLP-1, fasting glucagon-like peptide-1; nT2D, newly diagnosed type 2 diabetes mellitus; DPP4, dipeptidyl peptidase-IV; ELISA, enzyme-linked immunosorbent assay; BMI, body mass index; SD, standard deviation; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; hs-CRP, high-sensitivity C-reactive protein; 24hUA, 24-h urinary albumin; HOMA, homeostasis model assessment; HOMA-S, insulin sensitivity; HOMA-B, beta-cell function; HOMA-IR insulin resistance; OR, odds ratio; CI, confidence interval.

Acknowledgments

We regard to give the best thank you to all the staff in the Outpatients Department of the Vietnam Endocrinology Hospital for supporting the study.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare no potential conflicts of interest in this work.