Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K.
Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K.
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DOI：
10.2337/dc11-1108
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发表时间：
2011-10
期刊：
影响因子：
16.2
通讯作者：
Boulton AJ
中科院分区：
文献类型：
--
作者：
Abbott CA;Malik RA;van Ross ER;Kulkarni J;Boulton AJ
在一般糖尿病人群中评估：1）疼痛性神经病变症状的患病率; 2）神经病变症状与临床严重程度之间的关系; 3）糖尿病类型、性别和种族在疼痛性神经病变中的作用。对英格兰西北部接受社区卫生保健的糖尿病患者进行的大型队列观察性研究（n = 15，692）。采用神经病变症状评分（NSS）和神经病变残疾评分（NDS）评估疼痛性糖尿病神经病变（PDN）。疼痛症状（NSS ≥5）和PDN（NSS ≥5和NDS ≥3）的患病率分别为34%和21%。在无神经病变（NDS ≤2）的患者中，26%的患者出现疼痛症状，在有严重神经病变（NDS >8）的患者中，60%出现疼痛症状。2型糖尿病患者神经病变性疼痛症状的校正风险是1型糖尿病患者的两倍（比值比[OR] = 2.1 [95%CI 1.7-2.4]，P < 0.001），并且不受神经病变严重程度、胰岛素使用、足部畸形、吸烟或饮酒的影响。与男性相比，女性疼痛症状的校正风险增加50%（OR = 1.5 [1.4-1.6]，P < 0.0001）。尽管南亚人（14%）的神经病变比欧洲人（22%）和非洲加勒比人（21%）少（P < 0.0001），但南亚人的疼痛症状更严重（38%比34%比32%，P < 0.0001）。没有神经病变的南亚人与其他种族相比，疼痛性神经病变症状的风险增加了50%（P < 0.0001）。三分之一的社区糖尿病患者有疼痛性神经病变症状，无论他们的神经病变缺陷如何。PDN在2型糖尿病患者、女性和南亚裔人群中更为普遍。这突出了由于疼痛性神经病变引起的显著发病率，并确定了需要筛查PDN的关键群体。
To assess, in the general diabetic population, 1) the prevalence of painful neuropathic symptoms; 2) the relationship between symptoms and clinical severity of neuropathy; and 3) the role of diabetes type, sex, and ethnicity in painful neuropathy. Observational study of a large cohort of diabetic patients receiving community-based health care in northwest England (n = 15,692). Painful diabetic neuropathy (PDN) was assessed using neuropathy symptom score (NSS) and neuropathy disability score (NDS). Prevalence of painful symptoms (NSS ≥5) and PDN (NSS ≥5 and NDS ≥3) was 34 and 21%, respectively. Painful symptoms occurred in 26% of patients without neuropathy (NDS ≤2) and 60% of patients with severe neuropathy (NDS >8). Adjusted risk of painful neuropathic symptoms in type 2 diabetes was double that of type 1 diabetes (odds ratio [OR] = 2.1 [95% CI 1.7–2.4], P < 0.001) and not affected by severity of neuropathy, insulin use, foot deformities, smoking, or alcohol. Women had 50% increased adjusted risk of painful symptoms compared with men (OR = 1.5 [1.4–1.6], P < 0.0001). Despite less neuropathy in South Asians (14%) than Europeans (22%) and African Caribbeans (21%) (P < 0.0001), painful symptoms were greater in South Asians (38 vs. 34 vs. 32%, P < 0.0001). South Asians without neuropathy maintained a 50% increased risk of painful neuropathy symptoms compared with other ethnic groups (P < 0.0001). One-third of all community-based diabetic patients have painful neuropathy symptoms, regardless of their neuropathic deficit. PDN was more prevalent in patients with type 2 diabetes, women, and people of South Asian origin. This highlights a significant morbidity due to painful neuropathy and identifies key groups who warrant screening for PDN.
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影响因子：
3.6
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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