Racial and Ethnic Differences in Peripheral Neuropathy Risk Factors Among United States Adults

BACKGROUND AND OBJECTIVES: Peripheral neuropathy (PN) is a morbid condition. In the United States, there is higher prevalence of PN in non-Hispanic Black and Hispanic individuals vs non-Hispanic White individuals. Underlying mechanisms driving this increased prevalence are unknown. We aimed to determine associations between PN and race/ethnicity; other demographic information; and metabolic, lifestyle, and social determinants of health (SDOH) risk factors in a large and diverse sample of adults from the United States. METHODS: We performed a cross-sectional secondary analysis of the National Health and Nutrition Examination Survey from 1999 to 2004. PN was assessed using a monofilament test of reduced sensation. Risk factors included demographic (age, sex, race/ethnicity), metabolic (height, weight, waist circumference, systolic blood pressure, high-density lipoproteins, HbA1c), lifestyle (physical activity, diet), and SDOH (food security, household income, health insurance) information. Among individual risk factors, we found that age (1.05, 1.04-1.06), height (1.03, 1.02-1.05), HbA1c (1.13, 1.06-1.21), waist circumference (1.011, 1.005-1.017), and lack of health insurance (1.49, 1.16-1.92) were associated with PN. In stratified analyses, among Hispanic individuals, we found that the percentage of caloric intake from saturated fatty acids (1.06, 1.01-1.10) and food insecurity (1.48, 1.06-2.05) were associated with PN. DISCUSSION: We found that PN risk factors likely explain higher PN prevalence in non-Hispanic Black individuals but not among Hispanic individuals. We also determined SDOH risk factors-including being uninsured, and, in Hispanic individuals, experiencing food insecurity-increased the odds of PN, indicating the need for screening, prevention, and treatment of PN in persons with SDOH risk factors.