The Effect of Uric Acid as a Predisposing Factor on Polyneuropathy in Patients with Type 2 Diabetes Mellitus

Authors

  • Shahram Rafie Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Fatemeh Alemi Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Gholam Reza Shamsaei Department of Neurology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Mehrnoosh Zakerkish epartment of Endocrinology, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  • Leila Yazdanpanah Health research institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

DOI:

https://doi.org/10.6000/2292-2598.2020.08.02.11

Keywords:

Diabetes Mellitus, Polyneuropathy, Uric Acid.

Abstract

Background: Since serum uric acid is a controllable and modifiable factor in diabetic patients, identifying the risk factors and accelerating the incidence of neuropathy in these patients plays an important role, and can reduce its level, and the patient's disability, as well as additional therapeutic costs for the patient and the health system in the country.

Method: In this retrospective cohort study conducted at the Golestan Hospital in 2015-2017, the study population was 100 type 2 diabetic patients based on NCS of 54 patients with polyneuropathy. First, the demographic data on clinical examinations, lab tests, and uric acid levels in these patients were recorded on a checklist. Then, in 2017, patients were reassessed for clinical investigations and lab tests, and all data entered on the previous checklist. Finally, all the data were analyzed using the SPSS v23.

Results: The mean age of patients with polyneuropathy was 51.77 years, and there was a significant relationship between age, BMI and duration of diabetes with neuropathy, but there was no significant difference in gender, smoking and hypertension. The mean serum level of uric acid in the two years ago was 3.85 mg/dl, and at the time of the study, it was 4.18±1.55 mg/dl. There was no significant difference in serum levels of this substance after two years of follow up in patients with polyneuropathy (P=0.139). The incidence of polyneuropathy was reported by NCS findings of 54%. In other words, 54% of diabetic patients developed diabetic polyneuropathy for two years.

Conclusion: Polyneuropathy is a common complication in diabetic patients, and the serum levels of uric acid over time cannot have a significant effect on the incidence of this disorder.

References

Booya F, Bandarian F, Larijani B, Pajouhi M, Nooraei M, Lotfi J. Potential risk factors for diabetic neuropathy: a case control study. BMC Neurology 2005; 5(1): 24. https://doi.org/10.1186/1471-2377-5-24 DOI: https://doi.org/10.1186/1471-2377-5-24

Várkonyi T, Kempler P. Diabetic neuropathy: new strategies for treatment. Diabetes, Obesity and Metabolism 2008; 10(2): 99-108. DOI: https://doi.org/10.1111/j.1463-1326.2007.00741.x

Sugimoto K, Murakawa Y, Sima A. Diabetic neuropathy–a continuing enigma. Diabetes/metabolism Research and Reviews 2000; 16(6): 408-33. https://doi.org/10.1002/1520-7560(200011/12)16:6<408::AID-DMRR158>3.0.CO;2-R DOI: https://doi.org/10.1002/1520-7560(200011/12)16:6<408::AID-DMRR158>3.3.CO;2-I

Tesfaye S, Chaturvedi N, Eaton SE, Ward JD, Manes C, Ionescu-Tirgoviste C, et al. Vascular risk factors and diabetic neuropathy. New England Journal of Medicine 2005; 352(4): 341-50. https://doi.org/10.1056/NEJMoa032782 DOI: https://doi.org/10.1056/NEJMoa032782

Ziegler D, Rathmann W, Dickhaus T, Meisinger C, Mielck A. Prevalence of polyneuropathy in prediabetes and diabetes is associated with abdominal obesity and macroangiopathy. The Monica/Kora Augsburg Surveys S2 and S3. Diabetes Care 2007. https://doi.org/10.2337/dc07-1796 DOI: https://doi.org/10.2337/dc07-1796

Habib AA, Brannagan TH. Therapeutic strategies for diabetic neuropathy. Current Neurology and Neuroscience Reports 2010; 10(2): 92-100. https://doi.org/10.1007/s11910-010-0093-7 DOI: https://doi.org/10.1007/s11910-010-0093-7

Barbosa A, Medina J, Ramos E, Barros H. Prevalence and risk factors of clinical diabetic polyneuropathy in a Portuguese Primary Health Care Population 2001.

Papanas N, Papatheodorou K, Papazoglou D, Kotsiou S, Christakidis D, Maltezos E. An insertion/deletion polymorphism in the alpha2B adrenoceptor gene is associated with peripheral neuropathy in patients with type 2 diabetes mellitus. Experimental and Clinical Endocrinology & Diabetes 2007; 115(05): 327-30. https://doi.org/10.1055/s-2007-967084 DOI: https://doi.org/10.1055/s-2007-967084

Papanas N, Demetriou M, Katsiki N, Papatheodorou K, Papazoglou D, Gioka T, et al. Increased serum levels of uric acid are associated with sudomotor dysfunction in subjects with type 2 diabetes mellitus. Experimental Diabetes Research 2011; 2011. https://doi.org/10.1155/2011/346051 DOI: https://doi.org/10.1155/2011/346051

Meltzer S, Leiter L, Daneman D, Gerstein HC, Lau D, Ludwig S, et al 1998 clinical practice guidelines for the management of diabetes in Canada. Canadian Medical Association Journal 1998; 159: S1-S29.

Harder T, Franke K, Kohlhoff R, Plagemann A. Maternal and paternal family history of diabetes in women with gestational diabetes or insulin-dependent diabetes mellitus type I. Gynecologic and Obstetric Investigation 2001; 51(3): 160-4. https://doi.org/10.1159/000052916 DOI: https://doi.org/10.1159/000052916

Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014; 37(Supplement 1): S81-S90. https://doi.org/10.2337/dc14-S081 DOI: https://doi.org/10.2337/dc14-S081

Joslin EP, Kahn CR. Joslin's Diabetes Mellitus: Edited by Ronald Kahn C, et al. Lippincott Williams & Wilkins 2005.

Valk GD, Kriegsman D, Assendelft W. Patient education for preventing diabetic foot ulceration. A systematic review. Endocrinology and Metabolism Clinics of North America 2002; 31(3): 633-58. https://doi.org/10.1016/S0889-8529(02)00021-X DOI: https://doi.org/10.1016/S0889-8529(02)00021-X

Olaleye D, Perkins BA, Bril V. Evaluation of three screening tests and a risk assessment model for diagnosing peripheral neuropathy in the diabetes clinic. Diabetes Research and Clinical Practice 2001; 54(2): 115-28. https://doi.org/10.1016/S0168-8227(01)00278-9 DOI: https://doi.org/10.1016/S0168-8227(01)00278-9

Novella SP, Inzucchi SE, Goldstein JM. The frequency of undiagnosed diabetes and impaired glucose tolerance in patients with idiopathic sensory neuropathy. Muscle & Nerve 2001; 24(9): 1229-31. https://doi.org/10.1002/mus.1137 DOI: https://doi.org/10.1002/mus.1137

Ropper A, Samuels M, Klein J. Adams and Victor's Principles of Neurology 10th. McGraw-Hill Education 2014.

Olfatifar M, Karami M, Shokri P, Hosseini SM. Prevalence of chronic complications and related risk factors of diabetes in patients referred to the diabetes center of hamedan province 2017. https://doi.org/10.21859/nmj-25029 DOI: https://doi.org/10.21859/nmj-25029

Boya F, Larijani B, Pajouhi M, Lotfi J, Noraii MM, Bandarian F. Peripheral neuropathy in diabetic patients and its contributing factors. Iranian Journal of Diabetes and Lipid Disorders 2004; 3(1): 41-6.

Aaberg ML, Burch DM, Hud ZR, Zacharias MP. Gender differences in the onset of diabetic neuropathy. Journal of Diabetes and its Complications 2008; 22(2): 83-7. https://doi.org/10.1016/j.jdiacomp.2007.06.009 DOI: https://doi.org/10.1016/j.jdiacomp.2007.06.009

Pop‐Busui R, Lu J, Lopes N, Jones TL. Prevalence of diabetic peripheral neuropathy and relation to glycemic control therapies at baseline in the BARI 2D cohort. Journal of the Peripheral Nervous System 2009; 14(1): 1-13. https://doi.org/10.1111/j.1529-8027.2009.00200.x DOI: https://doi.org/10.1111/j.1529-8027.2009.00200.x

Lu B, Hu J, Wen J, Zhang Z, Zhou L, Li Y, et al. Determination of peripheral neuropathy prevalence and associated factors in Chinese subjects with diabetes and pre-diabetes–ShangHai Diabetic neuRopathy Epidemiology and Molecular Genetics Study (SH-DREAMS). PLoS One 2013; 8(4): e61053. https://doi.org/10.1371/journal.pone.0061053 DOI: https://doi.org/10.1371/journal.pone.0061053

Kargarian-Marvasti S, Rimaz S, Abolghasemi J, Heydari I. Comparing of Cox model and parametric models in analysis of effective factors on event time of neuropathy in patients with type 2 diabetes. Journal of Research in Medical sciences: the Official Journal of Isfahan University of Medical Sciences 2017; 22. https://doi.org/10.4103/jrms.JRMS_6_17 DOI: https://doi.org/10.4103/jrms.JRMS_6_17

Mueller MJ. Identifying patients with diabetes mellitus who are at risk for lower-extremity complications: use of Semmes-Weinstein monofilaments. Physical Therapy 1996; 76(1): 68-71. https://doi.org/10.1093/ptj/76.1.68 DOI: https://doi.org/10.1093/ptj/76.1.68

Downloads

Published

2020-05-15

How to Cite

Rafie, S., Alemi, F., Shamsaei, G. R., Zakerkish, M., & Yazdanpanah, L. (2020). The Effect of Uric Acid as a Predisposing Factor on Polyneuropathy in Patients with Type 2 Diabetes Mellitus. Journal of Intellectual Disability - Diagnosis and Treatment, 8(2), 167–173. https://doi.org/10.6000/2292-2598.2020.08.02.11

Issue

Section

General Articles