1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Copyright © 2022 Korean Diabetes Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conception or design: T.J.O., H.C.J., S.H.C.
Acquisition, analysis, or interpretation of data: T.J.O., Y.S.
Drafting the work or revising: T.J.O., S.H.C.
Final approval of the manuscript: T.J.O., Y.S., H.C.J., S.H.C.
FUNDING
This work was supported by a grant (Tae Jung Oh, 2016F-5) from the Korean Diabetes Association. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Values are presented as mean±standard deviation, number (%), or median (interquartile range). The P values were derived from the Student t-test, Mann-Whitney U test, or chi-square test.
DPN, diabetic peripheral neuropathy; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein-cholesterol; eGFR, estimated glomerular filtration rate; DPP-4, dipeptidyl peptidase-4; SGLT-2, sodium glucose cotransporter‐2; MNSI-PE, Michigan Neuropathy Screening Instrument Physical Examination; MNSI-Q, MNSI Questionnaire; ESC, electrochemical skin conductance.
Characteristic | Total (n=144) | DPN (–) (n=104) | Confirmed DPN (+) (n=40) | P value |
---|---|---|---|---|
Age, yr | 59.4±8.9 | 60.4±8.8 | 57.1±8.9 | 0.046 |
Male sex | 85 (59.0) | 53 (51.0) | 32 (80.0) | 0.002 |
Height, cm | 162.7±8.4 | 161.0±8.4 | 167.2±7.0 | <0.001 |
Body weight, kg | 67.5±11.5 | 67.1±10.7 | 68.7±13.4 | 0.458 |
BMI, kg/m2 | 25.4±3.5 | 25.8±3.3 | 24.4±3.7 | 0.027 |
SBP, mm Hg | 131.1±13.2 | 129.9±13.1 | 134.0±13.2 | 0.099 |
DBP, mm Hg | 75.0±9.5 | 74.5±9.4 | 76.3±9.8 | 0.293 |
Diabetes duration, yr | 9.5 (6.0–17.0) | 9.5 (6.0–17.0) | 9.5 (4.5–18.3) | 0.732 |
FPG, mg/dL | 137 (116–156) | 137 (116–157) | 138 (109–154) | 0.940 |
HbA1c, % | 7.1 (6.6–7.7) | 7.1 (6.6–7.5) | 7.1 (6.6–8.1) | 0.723 |
Cholesterol, mg/dL | 150 (133–171) | 152 (134–172) | 145 (128–168) | 0.168 |
Triglyceride, mg/dL | 111 (86–160) | 107 (86–155) | 130 (79–183) | 0.306 |
HDL-C, mg/dL | 46.5 (40.0–55.0) | 48 (41–57) | 44 (36–51) | 0.007 |
LDL-C, mg/dL | 87.8±23.6 | 88.2±23.2 | 86.9±24.9 | 0.774 |
eGFR, mL/min/1.73 m2 | 96.6±22.2 | 99.0±21.9 | 90.4±21.9 | 0.037 |
Hypertension | 81 (56.3) | 37 (48.7) | 17 (53.1) | 0.833 |
Lipid-lowering drugs | 109 (75.7) | 56 (73.7) | 23 (71.9) | 0.999 |
Insulin | 40 (27.8) | 14 (18.4) | 12 (37.5) | 0.048 |
Metformin | 134 (93.1) | 68 (89.5) | 31 (96.9) | 0.276 |
Sulfonylurea | 44 (30.6) | 24 (31.6) | 10 (31.3) | 0.999 |
DPP-4 inhibitor | 77 (53.5) | 40 (52.6) | 18 (56.3) | 0.833 |
SGLT-2 inhibitor | 22 (15.3) | 8 (10.5) | 2 (6.3) | 0.720 |
Thiazolidinedione | 19 (13.2) | 8 (10.5) | 3 (9.4) | 0.999 |
Medications for DPN | ||||
Pregabalin | 29 (20.1) | 18 (17.3) | 11 (27.5) | 0.245 |
Tricyclic antidepressant | 3 (2.1) | 3 (2.9) | 0 | 0.560 |
Duloxetine | 4 (2.8) | 3 (2.9) | 1 (2.5) | 0.999 |
Alpha-lipoic acid | 14 (9.7) | 8 (7.7) | 6 (15.0) | 0.213 |
Smoking | 0.856 | |||
Never | 67 (46.5) | 35 (46.1) | 13 (40.6) | |
Former | 49 (34.0) | 27 (35.5) | 12 (37.5) | |
Current | 28 (19.4) | 14 (18.4) | 7 (21.9) | |
Alcohol intake | 0.495 | |||
None | 67 (46.5) | 34 (44.7) | 16 (50.0) | |
Moderate | 72 (50.0) | 39 (51.3) | 16 (50.0) | |
High | 5 (3.5) | 3 (3.9) | 0 | |
Physically active | 95 (66.0) | 52 (68.4) | 19 (59.4) | 0.383 |
MNSI-PE score | 2.3 (1.0–4.0) | 2.0 (1.0–3.0) | 3.0 (1.6–3.5) | 0.117 |
MNSI-Q score | 2 (1–4) | 2 (1–4) | 3 (2–5) | 0.003 |
10-g monofilament (score) | 9 (9–10) | 10 (9–10) | 9 (7–10) | <0.001 |
Feet ESC, μS | 61.0 (48.0–70.0) | 62.0 (53.5–71.0) | 51.5 (29.8–67.8) | 0.002 |
Parameter | OR (95% CI) | P value | Score |
---|---|---|---|
MNSI-Q score | |||
<3 | Reference | ||
≥3 | 2.67 (1.26–5.66) | 0.011 | 3 |
MNSI-PE score | |||
≤2 | Reference | ||
>2 | 1.75 (0.83–3.67) | 0.139 | 2 |
10-g Monofilament test score | |||
≥7 | Reference | ||
<7 | 4.95 (1.51–16.21) | 0.008 | 5 |
Feet ESC, μS | |||
≥56 | Reference | ||
<56 | 4.11 (1.91–8.86) | <0.001 | 4 |
ROC area | 95% CI | P value | P compared to MNSI model | |
---|---|---|---|---|
MNSI model | 0.638 | 0.553–0.744 | 0.011 | NA |
SUDOSCAN model | 0.668 | 0.585–0.744 | 0.002 | 0.609 |
MNSI+SUDOSCAN model | 0.717 | 0.636–0.789 | <0.001 | 0.020 |
MNSI+10-g MF model | 0.674 | 0.591–0.750 | 0.001 | 0.278 |
Values are presented as mean±standard deviation, number (%), or median (interquartile range). The DPN, diabetic peripheral neuropathy; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein-cholesterol; eGFR, estimated glomerular filtration rate; DPP-4, dipeptidyl peptidase-4; SGLT-2, sodium glucose cotransporter‐2; MNSI-PE, Michigan Neuropathy Screening Instrument Physical Examination; MNSI-Q, MNSI Questionnaire; ESC, electrochemical skin conductance.
OR, odds ratio; CI, confidence interval; MNSI-Q, Michigan Neuropathy Screening Instrument Questionnaire; MNSI-PE, MNSI Physical Examination; ESC, electrochemical skin conductance.
ROC, receiver operating characteristic curve; CI, confidential interval; MNSI, Michigan Neuropathy Screening Instrument; NA, not available; MF, monofilament.