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Prevalence of Polyneuropathy in Prediabetes and Diabetes is Associated with Abdominal Obesity and Macroangiopathy. The MONICA/KORA Augsburg Surveys S2 and S3

¹Institute for Clinical Diabetes Research, German Diabetes Center, Leibniz Institute at the Heinrich Heine University, Düsseldorf, Germany
²Institute of Biometrics and Epidemiology, German Diabetes Center, Düsseldorf, Germany
³Institute of Epidemiology, GSF – National Research Center for Environment and Health, Neuherberg, Germany
⁴Institute of Health Economics and Health Care Management, GSF – National Research Center for Environment and Health, Neuherberg, Germany

dan.ziegler{at}ddz.uni-duesseldorf.de

ABSTRACT

Objective: It is controversial whether there is a glycemic threshold above which polyneuropathy (PN) develops, and which are the most important factors associated with PN in the general population. The aim of this study was to determine the prevalence and risk factors of PN in subjects with diabetes, impaired fasting glucose (IFG) and those with impaired and normal glucose tolerance (IGT,NGT).

Research Design and Methods: Subjects with diabetes (n=195) and controls matched for age and sex (n=198) from the population-based MONICA/KORA Augsburg Surveys 1989/90(S2) and 1994/95(S3) aged 25-74 years were contacted again and assessed in 1997/98 by the Michigan Neuropathy Screening Instrument using a score cutpoint >2. An oral glucose tolerance test was performed in the controls.

Results: Among the controls n=46 (23.2%) had IGT, n=71 (35.9%) had IFG, and n=81 had NGT. The prevalence of PN was 28.0% in the diabetic subjects, 13.0% in those with IGT, 11.3% in those with IFG, and 7.4% in those with NGT (p0.05 for diabetic vs NGT, IFG, and IGT). In the entire population studied (n=393), age, waist circumference, and diabetes were independent factors significantly associated with PN, while in the diabetic group PN was associated with age, waist circumference, and peripheral arterial disease (all p<0.05).

Conclusions: The prevalence of polyneuropathy is slightly increased in individuals with IGT and IFG compared to those with NGT. The association with waist circumference and peripheral arterial disease suggests that the latter and abdominal obesity may constitute important targets for strategies to prevent diabetic polyneuropathy.

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