Vági, Orsolya E;
Svébis, Márk M;
Domján, Beatrix A;
Körei, Anna E;
Tesfaye, Solomon;
Horváth, Viktor J;
Kempler, Péter;
(2023)
The association between distal symmetric polyneuropathy in diabetes with all-cause mortality – a meta-analysis.
Frontiers in Endocrinology
, 14
, Article 1079009. 10.3389/fendo.2023.1079009.
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Abstract
BACKGROUND: Distal symmetric polyneuropathy (DSPN) is a common microvascular complication of both type 1 and 2 diabetes with substantial morbidity burden and reduced quality of life. Its association with mortality is equivocal. PURPOSE: To describe the association between DSPN and all-cause mortality in people with diabetes and further stratify by the type of diabetes based on a meta-analysis of published observational studies. DATA SOURCES: We searched Medline from inception to May 2021. STUDY SELECTION: Original data were collected from case-control and cohort studies that reported on diabetes and DSPN status at baseline and all-cause mortality during follow-up. DATA EXTRACTION: was completed by diabetes specialists with clinical experience in neuropathy assessment. DATA SYNTHESIS: Data was synthesized using random-effects meta-analysis. The difference between type 1 and 2 diabetes was investigated using meta-regression. RESULTS: A total of 31 cohorts (n=155,934 participants, median 27.4% with DSPN at baseline, all-cause mortality 12.3%) were included. Diabetes patients with DSPN had an almost twofold mortality (HR: 1.96, 95%CI: 1.68-2.27, I2 = 91.7%), I2 = 91.7%) compared to those without DSPN that was partly explained by baseline risk factors (adjusted HR: 1.60, 95%CI: 1.37-1.87, I2 = 78.86%). The association was stronger in type 1 compared to type 2 diabetes (HR: 2.22, 95%CI: 1.43-3.45). Findings were robust in sensitivity analyses without significant publication bias. LIMITATIONS: Not all papers reported multiple adjusted estimates. The definition of DSPN was heterogeneous. CONCLUSIONS: DSPN is associated with an almost twofold risk of death. If this association is causal, targeted therapy for DSPN could improve life expectancy of diabetic patients.
| Type: | Article |
|---|---|
| Title: | The association between distal symmetric polyneuropathy in diabetes with all-cause mortality – a meta-analysis |
| Location: | Switzerland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fendo.2023.1079009 |
| Publisher version: | https://doi.org/10.3389/fendo.2023.1079009 |
| Language: | English |
| Additional information: | Copyright © 2023 Vági, Svébis, Domján, Körei, Tesfaye, Horváth, Kempler and Tabák. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | all-cause mortality, cohort studies, diabetes mellitus, distal symmetric polyneuropathy, meta-analysis, type 1 diabetes, type 2 diabetes, Humans, Diabetes Mellitus, Type 2, Diabetes Mellitus, Type 1, Quality of Life, Risk Factors, Polyneuropathies |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health of Older People |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10166462 |
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