Risk Factors for Developing Diabetic Peripheral Neuropathy: a Meta-analysis
Tirzah M. Fakkel, Nuray Çakici, J. Henk Coert, Arianne P. Verhagen, Wichor M. Bramer, Johan W. van Neck
Abstract
Abstract To identify risk factors for the development of diabetic peripheral neuropathy, systematic searches of PubMed, Embase, Web-of-Science, Cochrane and Google scholar databases were performed to conduct a meta-analysis of prospective studies that quantified major risk factors for diabetic peripheral neuropathy. Two authors independently extracted data for a random-effects meta-analysis. The standardized mean difference (SMD) and 95% CI for continuous data, and an odds ratio (OR) and 95% CI for dichotomous data were calculated. Of 7473 studies retrieved, 16 qualified studies were included. Contributing risk factors for developing diabetic peripheral neuropathy were age (SMD = 0.36; CI, 0.19 to 0.54; P < 0.01), body mass index (SMD = 0.31; CI, 0.20 to 0.42; P < 0.01), diabetes duration (SMD = 0.47; CI, 0.30 to 0.65; P < 0.01), estimated glomerular filtration rate (SMD = − 0.45; CI, − 0.63 to − 0.27; P < 0.01), fibrinogen (SMD = 0.10; CI, 0.01 to 0.19; P = 0.03), haemoglobin A1c (SMD = 0.24; CI, 0.16 to 0.32; P < 0.01), high-density lipoproteins (SMD = − 0.14; CI, − 0.21 to − 0.06; P < 0.01) systolic blood pressure (SMD = 0.31; CI, 0.10 to 0.52; P < 0.01), waist circumference (SMD = 0.39; CI, 0.14 to 0.64; P < 0.01), weight (SMD = 0.34; CI, 0.24 to 0.43; P < 0.01), cardiovascular disease (OR = 2.22; CI, 1.75 to 2.81; P < 0.01), foot ulcer history (OR = 1.90; CI, 1.09 to 3.33; P = 0.02), hypertension (OR = 1.90; CI, 1.24 to 2.89; P < 0.01), macroalbuminuria (OR = 2.96; CI, 2.02 to 4.35; P < 0.01), micro- or macroalbuminuria (OR = 1.73; CI, 1.43 to 2.08; P < 0.01), proliferative retinopathy (OR = 2.48; CI, 1.80 to 3.41; P < 0.01) and retinopathy (OR = 2.19; CI, 1.84 to 2.62; P < 0.01). Our findings show 17 risk factors that significantly contribute to the development of diabetic peripheral neuropathy.