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De Simone R.,Medicina Interna e Diabetologia | De Feo E.M.,Medicina Interna e Diabetologia | Piscopo G.,Medicina Interna e Diabetologia | Piscopo M.,Medicina Interna e Diabetologia | Rabitti P.G.,Medicina Interna e Diabetologia
Giornale Italiano di Diabetologia e Metabolismo | Year: 2010

Introduction. Diabetic neuropathy (DN) is one of the most serious diabetes mellitus complications, and it is the main cause of diabetic foot syndrome. Unfortunately, the risk factors for DN are not yet completely known. Aim. The aim of this study is to investigate possible associations between DN and obesity, particularly abdominal, assessed by measuring the waist circumference, and metabolic syndrome in outpatients with type 2 diabetes mellitus (T2DM). Research design and methods. We studied 294 patients (M/F: 166/128) with T2DM consecutively recruited at our outpatients department for DN. Patients were divided into two groups based on the presence (+) or absence (-) of DN. The two groups were compared for age, duration of diabetes, glycated haemoglobin (HbA1c), body mass index (BMI), waist circumference, height, weight, sex, metabolic syndrome (MS) diagnosed by NCEP ATP III criteria, blood pressure and plasma lipids. Results. The two groups did not differ for sex, height, diastolic blood pressure, serum total cholesterol, low density lipoproteins cholesterol (LDL-Col), high density lipoproteins cholesterol (HDL-Col), and triglycerides. The prevalence of hypertension (93.8% vs 75%, p < 0.001) and of metabolic syndrome (92% vs 71.7%, p < 0.001) was higher in DN+ patients. Mean patient's age (62.6 vs 57.9 years, p = 0.02) and median values of systolic blood pressure (150 vs 134 mmHg, p < 0.001), duration of diabetes (15 vs 5 years, p < 0.001), HbA1c (8 vs 6.75 %, p < 0.001), waist circumference (106 vs 101 cm, p < 0.001), BMI (29.8 vs 27.9, p = 0.003), and body weight (78.8 vs 74 kg, p = 0.021) were found higher in DN+ than in DN- patients. The multivariate logistic regression analysis showed that only the duration of diabetes, patient's age, HbA1c, and waist circumference were independently associated with DN. Finally, the analysis of drug consumption between the two groups showed that patients with neuropathy were more frequently treated with insulin (52.6% vs 14.2%, p < 0.001), whereas patients without neuropathy were more usually treated with oral diabetes medications (80.9% vs 63.4%, p = 0.02). Conclusion. Our study suggests that visceral obesity could be an independent risk factor for DN in patients with T2DM. If our data are confirmed, it will be possible to hypothesize that abdominal obesity could become an important target for DN prevention strategies.

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