Distal symmetrical polyneuropathy in prediabetes is associated with abdominal obesity and insulin resistance.

AIMS: To investigate the prevalence and clinical characteristics of distal symmetrical polyneuropathy (DSPN) in prediabetes and associations with cardiometabolic risk factors, insulin resistance and arterial stiffness.

METHODS

Consecutive adults with prediabetes attending the Outpatient Lipid and Obesity Clinic at the University Hospital of Ioannina, Greece were recruited. This is a cross sectional- analysis of the baseline characteristics of a prospective observational study. DSPN was diagnosed using the neuropathy symptom score (NSS), the neuropathy disability score (NDS) and the vibration perception threshold (VTP). Arterial stiffness was assessed with carotid-femoral pulse wave velocity (PWV).

RESULTS

We studied 160 consecutive adults with prediabetes, of whom 27 (16.9%) were diagnosed with DSPN. In multivariate analysis, waist circumference (OR: 1.092, 95% CI: 1.037-1.148, p < 0.001) and HOMA-IR (OR: 1.247, 95% CI: 1.095-1.425, p = 0.004) were independently associated with prevalent DSPN. Additionally, sensitivity analysis showed that current/previous smoking vs never-smoking (OR: 1.347, 95% CI: 1.116-1.891, p = 0.042) and height (OR: 1.083, 95% CI: 1.004-1.168, p = 0.039) were independently linked with prevalent DSPN. Subjects with DSPN had significantly higher median PWV (8.8 vs 8.0 m/s, p = 0.031) and prevalence of abnormal PWV (≥10 m/s) (29.6% vs 11.3%, p = 0.029) compared with no DSPN. PWV was independently associated with VPT (beta: 1.010, 95% CI:0.123-1.897, p = 0.026).

CONCLUSIONS

The prevalence of DSPN in prediabetes is not negligible in our study. DSPN is independently associated with central obesity and insulin resistance.