Relationship between diabetic neuropathic pain and comorbidity. Their impact on pain intensity, diabetes complications and quality of life in patients with type-2 diabetes mellitus
Relationship between diabetic neuropathic pain and comorbidity. Their impact on pain intensity, diabetes complications and quality of life in patients with type-2 diabetes mellitus
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DOI：
10.1016/j.diabres.2020.108236
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发表时间：
2020-07-01
影响因子：
5.1
通讯作者：
Failde, Inmaculada
中科院分区：
文献类型：
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作者：
Naranjo, Cristina;Ortega-Jimenez, Patricia;Failde, Inmaculada
目的：比较糖尿病神经性疼痛（DNP）患者和非糖尿病神经性疼痛患者的认知功能、情绪和睡眠状态及其与疼痛强度、糖尿病并发症和生活质量的关系。以确定这些关系是否因感觉表型而异。方法：对2型糖尿病合并神经病变患者进行横断面研究。测量DNP的存在、疼痛强度和表型、情绪状态、睡眠特征和生活质量。结果：共纳入130例患者，其中DNP患者65例。DNP与睡眠质量差（OR = 1.03;CI95%:1.02-1.05）、疼痛治疗（OR = 3.00,CI95%:1.24-7.29）或既往焦虑（OR = 2.70,CI95%:1.05-6.99）有关。有特定表型或抑郁的患者（=0.8 2,CI95%:-0.02-1.67）疼痛更严重。并发症与年龄较大（OR = 1.40,CI95%:1.12-1.66）、疼痛强度较高（OR = 1.51,CI95%:1.00-2.28）、认知能力较低（OR = 1.25,CI95%:1.09-1.43）、既往焦虑（OR = 10.48,CI95%:1.46-75）有关。24)和胰岛素治疗（OR = 124.50,CI95%:6.64-2335.06）。精神生活质量的下降与睡眠障碍（beta = -0.33,CI95%:-0.48,-0.23）、身体合并症（beta = - 9.73,CI95%:-18.15, -1.31）和既往焦虑（beta = -7.91,CI95%:-13.04, -2.77）有关。身体生活质量得分较低与睡眠障碍（beta = -0.12,CI95%: -0.21, - 0.18）、肥胖（beta = - 8.35,CI95%:-13.16, -3.55）、诊断时间较长（beta = -0.72,CI95%:-1.44;0.01）和残疾（beta = -14.58,CI95%:-24.69; -4.48）有关。结论：研究结果支持精神共病和睡眠障碍是DNP、疼痛强度增大、糖尿病并发症增多和生活质量降低的相关因素。此外，他们还强调了感觉表型与疼痛强度、认知能力低下和糖尿病并发症之间的关系。(C) 2020 Elsevier B.V.版权所有
Objective: To compare cognitive function, mood and sleep status in patients with and without diabetic neuropathic pain (DNP) and their relationship with pain intensity, diabetes complications, and quality of life. To determine whether these relationships differ depending on the sensorial phenotype.Methods: Cross-sectional study performed on patients with type-2 diabetes-mellitus and neuropathy. Presence of DNP, pain intensity and phenotype, mood status, sleep characteristics and quality of life were measured.Results: A total of 130 patients (65 with DNP) were included. DNP was related to poor sleep quality (OR = 1.03;CI95%:1.02-1.05), pain treatment (OR = 3.00,CI95%:1.24-7.29) or previous anxiety (OR = 2.70,CI95%:1.05-6.99). Patients with specific phenotypes or depression (=0.8 2,CI95%:-0.02-1.67) referred more severe pain. More complications were related to older age (OR = 1.40,CI95%:1.12-1.66), higher pain intensity (OR = 1.51,CI95%:1.00-2.28), lower cognitive performance (OR = 1.25,CI95%:1.09-1.43), previous anxiety (OR = 10.48,CI95%:1.46-75. 24) and insulin treatment (OR = 124.50,CI95%:6.64-2335.06). Decrease in mental quality of life was associated with sleep disorders (beta = -0.33,CI95%:-0.48,-0.23), physical comorbidities (beta = - 9.73,CI95%:-18.15, -1.31) and previous anxiety (beta = -7.91,CI95%:-13.04, -2.77). ower scores in physical quality of life were related to sleep disorders (beta = -0.12,CI95%: -0.21, - 0.18), obesity (beta = - 8.35,CI95%:-13.16, -3.55), longer time since diagnosis (beta = -0.72,CI95%:-1.44;0.01) and disability (beta = -14.58,CI95%:-24.69; -4.48).Conclusions: The results support the idea that mental comorbidity and sleep disorders are factors associated with DNP and greater pain intensity, more diabetes complications and lower quality of life. Moreover, they highlight the relationship between sensorial phenotypes and pain intensity, and lower cognitive performance and diabetes complications. (C) 2020 Elsevier B.V. All rights reserved.