The risk factors for diabetic peripheral neuropathy: A meta-analysis
The risk factors for diabetic peripheral neuropathy: A meta-analysis
复制标题
DOI：
10.1371/journal.pone.0212574
复制
发表时间：
2019-02-20
期刊：
影响因子：
3.7
通讯作者：
Zeng, Qibing
中科院分区：
文献类型：
--
作者：
Liu, Xiuxiu;Xu, Yuyan;Zeng, Qibing
糖尿病周围神经病变（DPN）是糖尿病最常见的慢性并发症，已成为全球重要的公共卫生危机。鉴于DPN治疗极其困难，确定其危险因素并及早控制对于预防其严重后果和社会疾病负担至关重要。目前的研究表明，糖尿病周围神经病变的危险因素是糖尿病病程、年龄、糖化血红蛋白A1c（HbA1c）、糖尿病视网膜病变（DR）、吸烟和体重指数（BMI）。但上述研究大多是横断面研究，样本量非常有限，因果推理的强度较低。本研究采用循证医学方法系统评价了2型糖尿病患者DPN的影响因素。总体而言，符合本标准的 16 项纳入研究（14 项横断面研究和 2 项病例对照研究，共 12,116 例病例）纳入最终分析。结果表明，糖尿病病程（MD 2.5，95% CI 1.71 与 3.29 相似）、年龄（MD 4.00，95% CI 3.05 与 4.95 相似）、HbA1c（MD 0.48，95% CI 0.33 与 0.64 相似）和 DR（OR 2.34，95% CI 1.74 与 0.64 相似） 3.16）与糖尿病患者 DPN 风险显着增加相关，而 BMI、吸烟、总甘油三酯 (TG) 和总胆固醇 (TC) 并不表明有任何增加 DPN 的风险。该研究结果为进一步了解2型糖尿病并发周围神经病变的病因及完善预防策略提供了科学依据。下一步是进行进一步的高质量前瞻性队列研究以验证本文的研究结果。
Diabetic peripheral neuropathy (DPN), the most common chronic complication of diabetes, has become an important public health crisis worldwide. Given that DPN is extremely difficult to treat, determining its risk factors and controlling it at an early stage is critical to preventing its serious consequences and the burden of social disease. Current studies suggest that the risk factors for diabetic peripheral neuropathy are the duration of diabetes, age, glycosylated hemoglobin A1c (HbA1c), diabetic retinopathy (DR), smoking, and body mass Index (BMI). However, most of the aforementioned studies are cross-sectional, and the sample sizes are very limited, so the strength of causal reasoning is relatively low. The current study systematically evaluated DPN's influencing factors in patients with type 2 diabetes using evidence-based medicine. Overall, 16 included studies (14 cross-sectional studies and 2 case-control studies including 12,116 cases) that conformed to the present criteria were included in the final analysis. The results suggested that the duration of diabetes (MD 2.5, 95% CI 1.71 similar to 3.29), age (MD 4.00, 95% CI 3.05 similar to 4.95), HbA1c (MD 0.48, 95% CI 0.33 similar to 0.64), and DR (OR 2.34, 95% CI 1.74 similar to 3.16) are associated with significantly increased risks of DPN among diabetic patients, while BMI, smoking, total triglyceride (TG), and total cholesterol (TC) did not indicate any risks of increasing DPN. The findings provide a scientific basis for a further understanding of the causes of type 2 diabetes complicated with peripheral neuropathy and the improvement of preventive strategies. The next step is to conduct further high-quality prospective cohort studies to validate this paper's findings.