Correlation Between Peripheral Neuropathy And Abdominal Fat Distribution In Type 2 Diabetes Mellitus

Background and objevtive:Diabetic mellitus and obesity have been on the rise in recent years as diets and lifestyles have changed.Diabetic peripheral neuropathy（DPN）is one of the most common complications of diabetic mellitus,and a large number of studies have confirmed the correlation between DPN and obesity.In 2004,Chinese Diabetes Society（CDS）pointed out that Chinese people are more prone to abdominal fat,and the distribution of body fat is characterized by abdominal obesity.At present,there is little and inconsistent evidence for the relationship between DPN and abdominal obesity.Based on the above views,this study aims to discuss the correlation between peripheral neuropathy in type 2 diabetes and abdominal fat distribution,identify new potential risk factors for DPN,and provide new ideas and clinical basis for the prevention of DPN.Method:Selected 600 patients with type 2 diabetic mellitus（325 males and 275 females）who hospitalized in the Endocrinology Department of China-Japan Union Hospital of Jilin University from January 2019 to December 2019.Collected patients’general data and biochemical indicators,including age,gender,duration of diabetic mellitus,height,weight,blood pressure,smoking,drinking,neurological examination,abdominal visceral fat area and subcutaneous fat area measurement,determination of glycosylated hemoglobin,fasting blood glucose,two-hour postprandial blood glucose,triglyceride,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol and blood uric acid.First of all,the ratio of visceral fat area and subcutaneous fat area（V/S）was used to represent the distribution of abdominal fat.Patients were divided into four groups according to the V/S quadrate.Through statistical analysis of the data,the general characteristics between the four groups and the risk of DPN were compared.Secondly,according to the diagnosis of DPN,patients were divided into DPN group and non-DPN group.Through statistical analysis of the data,the general characteristics between the two groups were compared,and other relevant risk factors of DPN were evaluated.Results:The mean age of all patients was 53.80±11.79 years old,the mean duration of diabetic mellitus was 8.58±7.00 years,the mean V/S was 0.4639±0.1486,and the detection rate of DPN was 45.2%.There were significant differences in gender,smoking,drinking,hypertension,BMI,TG,HDL-C and UA among different groups（all P<0.05）.However,there were no significant differences in age,duration of diabetic mellitus,SBP,DBP,HbA1c,FBG,2hPG,TC,LDL-C,DR,DKD and PAD among different groups（all P>0.05）.The detection rate of DPN in different V/S groups was 36.7%,41.3%,48.0%and 54.7%（P=0.011）.After adjusting for age,gender,duration of diabetic mellitus,smoking,HbA1c and TG,the results of binary Logistic regression analysis showed that,compared with group P_≤25,the risk of DPN in group P_>25,≤50and group P_>50,≤75increased,but there were not statistically significant（all P>0.05）,while the risk of DPN in group P_>7575 increased by 75.6%（OR=1.756,95%CI:1.023-3.015,P=0.041）.There were statistical differences in abdominal obesity,hypertension,DKD,PAD,age,duration of diabetic mellitus,SBP,VFA,SFA,V/S and FBG between the DPN group and the non-DPN group（all P<0.05）,while there were no significant differences in smoking,drinking,DR,DBP,BMI,HbA1c,2hPG,TG,TC,HDl-C and LDL-C between the two groups（all P>0.05）.Multivariate Logistic regression analysis showed that age（OR=1.084,95%CI:1.062-1.107,P<0.001）,BMI（OR=1.072,95%CI:1.014-1.133,P=0.014）,HbA1c（OR=1.152,95%CI:1.050-1.263,P=0.003）and PAD（OR=1.687,95%CI:1.064-2.677,P=0.026）were the risk factors for DPN.Conclusions:High V/S is positively correlated with DPN,and high V/S is a risk factor for DPN,suggesting that V/S ratio can predict the risk of DPN.In addition,age,BMI,HbA1c and PAD are also risk factors for DPN.