The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country.
The prevalence, patterns and predictors of diabetic peripheral neuropathy in a developing country.
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DOI：
10.1186/1758-5996-4-21
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发表时间：
2012-05-29
影响因子：
4.8
通讯作者：
Matthews DR
中科院分区：
文献类型：
--
作者：
Katulanda P;Ranasinghe P;Jayawardena R;Constantine GR;Sheriff MH;Matthews DR
在斯里兰卡，糖尿病患病率已达到流行病的程度。目前，有关于斯里兰卡远端周围神经病变（DPN）社区患病率的研究。我们描述了斯里兰卡糖尿病患者DPN的患病率、模式和预测因素。数据收集作为国家糖尿病研究的一部分。在新发病例中，使用糖尿病神经病变症状（DNS）评分评估DPN，而在确诊糖尿病的病例中，使用DNS和多伦多临床评分系统（TCSS）。以“是否存在DPN”作为二值因变量和其他独立协变量进行二元逻辑回归分析。该研究纳入了528名糖尿病患者（191例新发病例），平均年龄为55.0 ± 12.4岁，37.3%为男性，18%来自城市地区。根据DNS评分，DPN在所有患者、已确诊糖尿病患者和新诊断患者中的患病率分别为48.1%、59.1%和28.8%。经TCSS评估，确诊DM患者中DPN的患病率为24%，大多数患者为轻度DPN（16.6%）。摘要的其余部分基于确诊DM的受试者。DPN患病率男性为20.0%，女性为26.4%。DPN组与非DPN组的平均年龄分别为62.1 ± 10.8岁和55.1 ± 10.8岁（P < 0.001）。大多数DPN患者来自农村地区（75.3%），月收入<12，000斯里兰卡卢比（87.6%）。在足部溃疡的二元逻辑回归中，（OR：10.4; 95%CI 1.8-16.7），女性（OR：6.7; 95%CI 2.0-9.8）和吸烟（OR：5.9; 95%CI 1.4-9.7）是最强的预测因子，其次是胰岛素治疗（OR：4.3; 95%CI 1.3-6.9），糖尿病视网膜病变（OR：2.7; 95%CI 1.3-5.4），磺脲类药物治疗（OR：1.8; 95%CI 1.1-3.2），身高增加（OR：1.8; 95%CI 1.2-2.4），农村居民（OR：1.8; 95%CI 1.1-2.5），甘油三酯水平较高（OR：1.6; 95%CI 1.2-2.0）和DM持续时间较长（OR：1.2; 95%CI 1.1-1.3）。有一个高患病率的DPN斯里兰卡成人糖尿病患者。该研究定义了先前已知的DPN发展风险因素的影响，并在不同种族的大型DM亚群中确定了几个新的潜在风险因素。
Prevalence of diabetes mellitus (DM) has reached epidemic proportions in Sri Lanka. Presently there are studies on the community prevalence of distal peripheral neuropathy (DPN) in Sri Lanka. We describe prevalence, patterns and predictors of DPN in patients with DM in Sri Lanka. Data were collected as part of a national study on DM. In new cases DPN was assessed using the Diabetic-Neuropathy-Symptom (DNS) score, while in those with established diabetes both DNS and Toronto-Clinical-Scoring-System (TCSS) were used. A binary logistic-regression analysis was performed with ‘presence of DPN’ as the dichomatous dependent variable and other independent co-variants. The study included 528 diabetic patients (191-new cases), with a mean age of 55.0 ± 12.4 years and 37.3% were males, while 18% were from urban areas. Prevalence of DPN according to DNS score among all patients, patients with already established diabetes and newly diagnosed patients were 48.1%, 59.1% and 28.8% respectively. Prevalence of DPN in those with established DM as assessed by TCSS was 24% and the majority had mild DPN (16.6%). The remainder of the abstract is based on subjects with established DM. The prevalence of DPN in males and female was 20.0% and 26.4% respectively. The mean age of those with and without DPN was 62.1 ± 10.8 and 55.1 ± 10.8 years respectively (p < 0.001). The majority of those with DPN were from rural-areas (75.3%) and earned a monthly income < Sri Lankan Rupees 12,000 (87.6%). In the binary logistic-regression presence of foot ulcers (OR:10.4; 95%CI 1.8–16.7), female gender (OR:6.7; 95%CI 2.0–9.8) and smoking (OR:5.9; 95%CI 1.4–9.7) were the strongest predictors followed by insulin treatment (OR:4.3; 95%CI 1.3–6.9), diabetic retinopathy (OR:2.7; 95%CI 1.3–5.4), treatment with sulphonylureas (OR:1.8; 95%CI 1.1–3.2), increasing height (OR:1.8; 95%CI 1.2–2.4), rural residence (OR:1.8; 95%CI 1.1–2.5), higher levels of triglycerides (OR:1.6; 95%CI 1.2–2.0) and longer duration of DM (OR:1.2; 95%CI 1.1–1.3). There is a high prevalence of DPN among Sri Lankan adults with diabetes. The study defines the impact of previously known risk factors for development of DPN and identifies several new potential risk factors in an ethnically different large subpopulation with DM.
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通讯作者：
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DOI：
10.4103/0973-3930.60004
发表时间：
2010-01
影响因子：
0.9
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Hussain A