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Risk factors and pain status due to diabetic neuropathy in chronic long-term diabetic patients in a chinese urban population

引用

chinese Medical Journal 2012年第23期125卷 4190-4196页

作者： JI Na ZHANG Nan REN Zhan-jie JIA Ke-bao WANG Li NI Jia-xiang MA Jun Department of Pain Management Xuanwu Hospital Capital MedicaJ University Beijing 100053 China Department of Endocrinology Xuanwu Hospital Capital MedicaJ University Beijing 100053 China Department of Anesthesiology Xuanwu Hospital Capital MedicaJ University Beijing 100053 China Department of Urology Second Affiiated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310009 China

Background With economic growth and urbanization there have been significant changes in the life style and diet of urban residents in large cities of China, which is experiencing a rapid increase in the prevalence of diabetes. While high prevalence of diabetes has been reported, little is known of the long-term effects of diabetes in such a large population. The aim of this study was to estimate the morbidity rate of diabetic peripheral neuropathy （DPN） in a chinese urban diabetic population with more than 10 years＇ disease duration, and evaluate the relevant risk factors. The clinical manifestation of DPN and pain status was also assessed. Methods Five hundred and sixty-five diabetes patients were recruited into the study. Symptoms and examination helped diagnose neuropathy. The clinical manifestation of DPN was assessed with a visual analog pain score （VAS）. Diabetic complication status was determined from medical records. Serum lipids and lipoproteins, glycosylated hemoglobin （HbAlc）, and the urinary albumin excretion rate were measured. Results The morbidity rate of DPN was 46.6%. HbAlc, hyperlipidemia, and retinopathy were significantly associated with neuropathy, and these risk factors were correlated with other diabetic micro and/or macrovascular complications. The average VAS pain score of the DPN patients was 4.12＋2.07. Severe and moderate pain was experienced by 11.4% and 40.5% respectively of DPN patients. About 3.7% of diabetic subjects had lower limb ulcer or amputation. Conclusions The morbidity rate of DPN for diabetic patients with 〉10 years duration is very high compared to the range reported for other populations in the world. The risk factors for DPN include HbAlc, hyperlipidemia, and retinopathy. In long-standing diabetic patients, DPN was not associated with diabetic duration, and half of the DPN patients experienced considerable daily suffering.

关键词： Diabetic neuropathy risk factors pain status urban chinese population

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