Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China; Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China.
Xijing Hospital of PLA Air Force Medical University, Xi'an, Shanxi Province, China.
Diabetes Res Clin Pract. 2023 Apr;198:110602. doi: 10.1016/j.diabres.2023.110602. Epub 2023 Mar 4.
The study aimed to assess the prevalence and risk factors of painful diabetic peripheral neuropathy (PDPN) in patients with type 2 diabetes mellitus (T2DM) and diabetic peripheral neuropathy (DPN) in mainland China.
This nationwide cross-sectional study enrolled T2DM patients with DPN from 25 provinces in China between July 2017 and December 2017. The prevalence, characteristics, and risk factors of PDPN were analyzed.
Among 25,710 patients with T2DM and DPN, 14,699 (57.2%) had PDPN. The median age was 63 years old. Age over 40 years old, education level, hypertension, myocardial infarction, duration of diabetes of over five years, diabetic retinopathy and nephropathy, moderate total cholesterol, moderate and higher low-density lipoprotein (LDL) increased uric acid (UA) and decreased estimated glomerular filtration rate (eGFR) were independently associated with PDPN (all P < 0.05). Compared with low levels of C-peptide, moderate levels were independently associated with a higher risk of PDPN, while high levels were associated with a lower risk (all P < 0.001).
In mainland China, more than half of the patients with DPN have neuropathic pain. Patients with older age, lower education level, longer duration of diabetes, lower LDL, increased UA, decreased eGFR, and comorbidities had an increased risk of PDPN.
本研究旨在评估中国 25 个省份的 25710 例 2 型糖尿病(T2DM)合并糖尿病周围神经病变(DPN)患者中,疼痛性糖尿病周围神经病变(PDPN)的患病率及相关危险因素。
这是一项全国性的横断面研究,于 2017 年 7 月至 12 月期间招募了中国 25 个省份的 T2DM 合并 DPN 患者。分析了 PDPN 的患病率、特征和危险因素。
在 25710 例 T2DM 合并 DPN 患者中,14699 例(57.2%)患有 PDPN。患者的中位年龄为 63 岁。年龄超过 40 岁、教育程度、高血压、心肌梗死、糖尿病病程超过 5 年、糖尿病视网膜病变和肾病、总胆固醇中度升高、中、高 LDL 及尿酸升高、估算肾小球滤过率降低与 PDPN 相关(均 P<0.05)。与低水平 C 肽相比,中水平 C 肽与 PDPN 风险增加独立相关,高水平 C 肽与 PDPN 风险降低独立相关(均 P<0.001)。
在中国,超过一半的 DPN 患者有神经病理性疼痛。年龄较大、教育程度较低、糖尿病病程较长、LDL 较低、UA 升高、eGFR 降低以及合并症的患者发生 PDPN 的风险增加。