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

Figures & data

Table 1 The Demographic and Biomedical Characteristics of the Study Population

Variables, Unit	Men	Women	Overall
	(n = 247)	(n = 226)	(n = 473)
Age, years	52.00 (44.00–59.00)^++	55.00 (50.00–62.00)^++	54.00 (47.00–60.00)
BMI, kg/m^2	22.40 (20.80–24.24)	22.00 (20.11–24.20)	22.12 (20.31–24.21)
Waist circumference, cm	84.84 ± 8.00^++	81.16 ± 8.45^++	83.30 ± 8.35
Hip circumference, cm	93.00 (89.00–97.00)^+	90.00 (86.00–95.00)^+	92.00 (87.00–96.50)
Waist–hip radito	0.91 (0.88–0.94)^++	0.89 (0.86–0.93)^++	0.90 (0.87–0.94)
Smoking	103 (47.1)^++	1 (0.4)^++	104 (22.0)
Drinking	162 (65.6)^++	5 (2.2)^++	167 (35.3)
SBP, mmHg	123.00 (120.00–140.00)	120.00 (114.50–140.00)	120.00 (120.00–140.00)
DBP, mmHg	80.00 (70.00–80.00)^+	80.00 (70.00–80.00)^+	80.00 (70.00–80.00)
FPG, mmol/L	9.90 (7.50–11.70)^+	9.85 (7.47–14.3)^+	10.70 (7.80–15.25)
HbA1c, %	11.80 (8.10–15.60)^+	8.91 (7.08–11.40)^+	9.50 (7.20–11.40)
C-peptide, nmol/L	0.74 (0.48–1.01)	0.76 (0.54–1.20)	0.75 (0.50–1.15)
Insulin, pmol/L	61.44 (38.05–95.50)^+	70.86 (45.60–106.77)^+	65.64 (41.64–104.83)
Albumin, g/L	41.15 (38.55–44.00)	41.00 (39.00–44.00)	41.10 (39.00–44.00)
Triglycerides, mmol/L	2.16 (1.44–3.65)	2.00 (1.36–3.28)	2.09 (1.40–3.40)
Total cholesterol, mmol/L	5.3 (4.36–6.16)	5.3 (4.51–6.20)	5.30 (4.41–6.17)
HDL-C, mmol/L	1.17 (0.99–1.43)^+	1.24 (1.07–1.50)^+	1.19 (1.02–1.48)
LDL-C, mmol/L	3.07 (2.45–4.08)	3.12 (2.40–4.02)	3.10 (2.43–4.05)
Lipid disorders, positive	211 (85.8)	182 (80.8)	393 (83.3)
Alanine transferase, U/L	27.00 (21.00–38.00)	26.00 (20.00–35.00)	27.00 (21.00–36.00)
Aspartate transferase, U/L	34.00 (24.00–52.00)^++	29.00 (20.75–44.00)^++	31.00 (22.00–49.00)
Creatinine, μmol/L	84.00 (75.00–92.00)^++	69.00 (62.00–76.00)^++	76.00 (67.00–86.00)
fGLP-1, pmol/L	6.25 (4.46–9.71)	6.49 (5.20–9.00)	6.37 (4.81–9.13)
hsCRP, mg/L	2.10 (1.01–5.22)	2.04 (1.01–4.56)	2.10 (1.01–4.79)
Potassium ion, mmol/L	3.90 (3.70–4.10)	3.80 (3.70–4.00)	3.90 (3.70–4.00)
Sodium ion, mmol/L	137.00 (135.00–139.00)^++	138.00 (136.00–140.00)^++	137.00 (136.00–139.00)
White blood cells (G/L)	7.88 (6.52–9.50)	7.50 (6.40–9.10)	7.72 (6.50–9.27)
24hUA, mg	3.98 (0.00–13.09)	3.04 (0.00–8.48)	3.61 (0.00–11.50)
24hUA, (≥30 mg)	21 (9.1)	16 (7.3)	37 (8.2)
HOMA-S (%)	43.40 (28.25–62.03)	42.90 (26.50–66.00)	43.20 (27.15–63.70)
HOMA-B (%)	32.35 (16.80–62.10)^+	42.40 (23.90–78.00)^+	36.20 (20.20–69.00)
HOMA-IR	2.30 (1.61–3.58)	2.33 (1.54–3.77)	2.31 (1.57–3.70)
Diabetic retinopathy	15 (6.6)	13 (6.2)	28 (6.4)

Notes: Data were expressed as mean±SD or median and interquartile range (Q1-Q3); ⁺P < 0.05; ⁺⁺P < 0.001 (between male and female group).

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; fGLP-1, fasting glucagon-like peptide-1; hs-CRP, high-sensitivity C-reactive protein; 24hUA, 24-h urinary albumin; HOMA-S, insulin sensitivity; HOMA-B, beta-cell function; HOMA-IR insulin resistance.

Table 2 The Prevalence and Grade of Diabetic Peripheral Neuropathy in the Newly Diagnosed Patients with Type 2 Diabetes Mellitus

Variables		Men	Women	Overall
		(n = 247)	(n = 226)	(n = 473)
Peripheral Diabetic Neuropathy
	Positive	66 (14.0)	60 (12.6)	126 (26.6)
	Negative	181 (38.3)	166 (35.1)	347 (73.4)
	p*-Value	p = 0.966
Grade
	Mild	44 (9.3)	38 (8.0)	82 (17.3)
	Moderate	18 (3.8)	21 (4.4)	39 (8.2)
	Severe	4 (0.8)	1 (0.3)	5 (1.1)
	p*-Value	p = 0.534

Note: *Chi-square tests; p-value (between men and women).

Table 3 The Relationship Between Cardiovascular Risk Factors and Diabetic Peripheral Neuropathy in the Newly Diagnosed Patients with Type 2 Diabetes Mellitus

Variables, Unit		Peripheral Diabetic Neuropathy
		Positive	Negative	p*; OR, 95% CI
Age, years	<60 (n = 334)	78 (24.4)	256 (76.6)	p=0.012 OR=1.73 (1.12–2.67)
	≥60 (n = 139)	48 (34.5)	91 (65.5)
Smoking	Active (n = 104)	36 (34.6)	68 (65.4)	p=0.037 OR=1.64 (1.03–2.62)
	None (n = 369)	90 (24.4)	279 (75.6)
Drinking	Active (n = 167)	47 (28.1)	120 (71.9)	p=0.584
	None (n = 306)	79 (25.8)	227 (74.2)
Hypertension	Positive (n = 141)	44 (31.2)	97 (68.8)	p=0.143
	Negative (n = 332)	82 (24.7)	250 (75.3)
BMI, kg/m^2	<23 (n = 278)	72 (25.9)	206 (74.1)	p=0.664
	≥23 (n = 195)	54 (27.7)	141 (72.3)
Lipid disorders	Positive (n = 393)	110 (28.0)	283 (72.0)	p=0.156
	Negative (n = 79)	16 (20.3)	83 (79.7)
Glucose control	Good–normal (n = 71)	19 (26.8)	52 (73.2)	p=0.98
	Poor (n = 402)	107 (26.6)	295 (73.4)
HbA1c control	Good-normal (n = 61)	8 (13.1)	53 (86.9)	p=0.01 OR=2.66 (1.23–5.76)
	Poor (n = 412)	118 (28.6)	294 (71.4)
24hUA, mg	≥30 (n = 37)	17 (45.9)	20 (54.1)	p=0.007 OR=2.49 (1.26–4.94)
	<30 (n = 413)	105 (25.4)	308 (74.6)
Diabetic retinopathy	Positive (n = 28)	14 (50.0)	14 (50.0)	p=0.002 OR=3.17 (1.46–6.89)
	Negative (n = 409)	98 (24.0)	311 (76.0)

Note: *Chi-square tests.

Abbreviations: BMI, body mass index; 24hUA, 24-h urinary albumin; OR, odds ratio; CI, confidence interval.

Table 4 The Relationship Between Fasting GLP-1 Concentrations and Diabetic Peripheral Neuropathy in the Newly Diagnosed Patients with Type 2 Diabetes Mellitus

	Diabetic Peripheral Neuropathy
	Positive	Negative
Mean rank (n)
Male	28.24 (27)	52.90 (63)
Female	37.22 (29)	42.36 (51)
Overall	66.41 (56)	94.88 (114)
Median fGLP-1 (pmol/l) (n)
Male	4.11 (27)	6.91 (63)
Female	6.37 (29)	6.64 (51)
Overall	5.27 (56)	6.76 (114)
Test Statistics**
Male	Z = −4.103; p < 0.001, n = 90
Female	Z = −0.951; p = 0.342, n = 80
Overall	Z = −3.554; p < 0.001, n = 170

Note: **Mann–Whitney U-tests.

Abbreviation: fGLP-1, fasting glucagon-like peptide-1.

Table 5 The Multivariate Logistic Regression Analysis Associated Other Factors with Diabetic Peripheral Neuropathy in the Newly Diagnosed Patients with Type 2 Diabetes Mellitus

Determinants, Unit	B	p	OR	95% CI
Hypertension (0 = negative, 1 = positive)	1.084	0.023	2.96	1.16–7.55
HbA1c, %	0.196	0.042	1.22	1.01–1.47
Triglyceride, mmol/L	0.404	0.009	1.50	1.11–2.03
Albumin, g/L	−0.166	0.005	0.85	0.75–0.95
fGLP-1, pmol/L	−0.235	0.005	0.79	0.67–0.93
HOMA-B, %	0.006	0.407	1.01	0.99–1.02
Urea, mmol/L	−0.177	0.267	0.84	0.61–1.15
Gender (1 = male, 2 = female)	0.585	0.185	1.79	0.76–4.26
Potassium ion, mmol/L	0.484	0.408	1.62	0.52–5.11
HDL-C, mmol/L	0.794	0.110	2.21	0.84–5.86
LDL-C, mmol/L	−0.108	0.578	0.90	0.61–1.31
White blood cells, G/L	−0.068	0.430	0.93	0.79–1.11
BMI (0 = BMI < 23, 1 = BMI ≥ 23 (kg/m^2))	0.410	0.362	1.51	0.62–3.64
Glucose control (0 = good–normal, 1 = poor)	−1.100	0.140	0.33	0.08–1.43

Abbreviations: fGLP-1, fasting glucagon-like peptide-1; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; HOMA-B, beta-cell function; BMI, body mass index; OR, odds ratio; CI, confidence interval.