Risk Factors for Developing Diabetic Peripheral Neuropathy: a Meta-analysis

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.