Whether coagulation dysfunction influences the onset and progression of diabetic peripheral neuropathy: A multicenter study in middle-aged and aged patients with type 2 diabetes.

Autor: Xie J; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, P.R. China., Yu X; Alberta Institute, Wenzhou Medical University, Wenzhou, China., Chen L; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China., Cheng Y; Department of Neurology, Center for Rehabilitation Medicine Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China., Li K; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China., Song M; Department of Neurology, First Clinical College of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, Ruian People's Hospital, Wenzhou, P.R. China., Chen Y; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, First Clinical College of Wenzhou Medical University, Wenzhou, P.R. China., Feng F; Department of Neurology, First Clinical College of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, Shaoxing People's Hospital, Shaoxing, P.R. China., Cai Y; Department of Neurology, Anyang District Hospital, Beiguan District, Anyang, Henan, China., Tong S; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China., Qian Y; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China., Xu Y; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China., Zhang H; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, First Clinical College of Wenzhou Medical University, Wenzhou, P.R. China., Yang J; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, First Clinical College of Wenzhou Medical University, Wenzhou, P.R. China., Xu Z; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.; Department of Neurology, First Clinical College of Wenzhou Medical University, Wenzhou, P.R. China., Cui C; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden., Yu H; Department of Pediatrics, Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, P.R. China., Deng B; Department of Neurology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China.
Jazyk: angličtina
Zdroj: CNS neuroscience & therapeutics [CNS Neurosci Ther] 2024 Sep; Vol. 30 (9), pp. e70040.
DOI: 10.1111/cns.70040
Abstrakt: Background: Nearly half of patients with diabetes experience diabetic peripheral neuropathy (DPN), resulting in a mere 53% survival rate within 3 years. Aberrations in coagulation function have been implicated in the pathogenesis of microvascular complications, prompting the need for a thorough investigation into its role as a contributing factor in the development and progression of DPN.
Methods: Data were gathered from 1211 type 2 diabetes patients admitted to five centers from September 2018 to October 2022 in China. DPN was evaluated by symptoms and electromyography. Motor and sensory nerve conduction velocity (NCV) was appraised and the NCV sum score was calculated for the median, ulnar, and peroneal motor or sensory nerves.
Results: Patients with DPN exhibited alterations in coagulation function. (i) Specifically, they exhibited prolonged thrombin time (p = 0.012), elevated fibrinogen (p < 0.001), and shortened activated partial thromboplastin time (APTT; p = 0.026) when compared to the control group. (ii) After accounting for potential confounders in linear regression, fibrinogen, and D-dimer were negatively related to the motor NCV, motor amplitude values, and mean velocity and amplitude. Also, fibrinogen was associated with higher Michigan neuropathy screening instrument (MNSI) scores (β 0.140; p = 0.001). This result of fibrinogen can be validated in the validation cohort with 317 diabetic patients. (iii) Fibrinogen was independently associated with the risk of DPN (OR 1.172; p = 0.035). In the total age group, DPN occurred at a slower rate until the predicted fibrinogen level reached around 3.75 g/L, after which the risk sharply escalated.
Conclusions: Coagulation function is warranted to be concerned in patients with type 2 diabetes to predict and prevent the occurrence of DPN in clinical practice.
(© 2024 The Author(s). CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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