Key result
In patients with type 2 diabetes, lower systolic blood pressure levels were significantly associated with the absence of diabetic peripheral neuropathy (SMD -2.63).
Why the study?
Compositional abnormalities in lipoproteins and cardiovascular risk factors play an important role in the progression of diabetic peripheral neuropathy, but the predictive value of LDL and SBP levels was unclear.
Are serum LDL and SBP levels associated with the presence of peripheral neuropathy in patients with type 2 diabetes?
Meta-Analysis (n=355,438)
Are serum LDL and SBP levels associated with the presence of peripheral neuropathy in patients with type 2 diabetes?
Standardized Mean Difference: -2.63 (95% CI -4–-1.27)
Absolute Event Rate: 138.45% vs 141.08%
p-value: p=<0.001
Higher systolic blood pressure and LDL levels are associated with an increased risk of peripheral neuropathy in patients with type 2 diabetes.
Hypothesis-generating for neuropathy prevention; should not yet change BP targets in type 2 diabetes.
BACKGROUND: Compositional abnormalities in lipoproteins and cardiovascular risk factors play an important role in the progression of diabetic peripheral neuropathy (DPN). This systematic review aimed to estimate the predicting value of low-density lipoprotein (LDL) and systolic blood pressure (SBP) level in type-2 diabetes mellitus (T2DM) patients with and without peripheral neuropathy. We also tried to determine whether LDL and SBP are associated with an increased collision risk of DPN. METHODS: A systematic search was conducted for eligible publications which explored the LDL and SBP level in T2DM patients with and without peripheral neuropathy. The quality of the included studies was assessed by the QUADAS-2 tool. The standardized mean difference (SMD) with 95% CI of LDL and SBP level were pooled to assess the correlation between LDL and SBP level with DPN. We performed random effects meta-regression analyses to investigate factors associated with an increased collision risk of DPN. RESULTS: = 84.9%, respectively, Both P < 0.001). European T2DM patients have higher serum level of LDL in compare with the European DPN patients (SMD = 0.16, 95% CI: - 0.06 - 0.38; P < 0.001). SBP level was associated with a 2.6-fold decrease in non-DPN patients of T2DM (SMD = - 2.63, 95% CI: - 4.00 - -1.27, P < 0.001). Old age European T2DM patients have significantly high risk for diabetes drivers. Furthermore, the results of the case-control study design model are more precise to show the accuracy of SBP in Asian T2DM patients. CONCLUSION: Our finding supports the LDL and SBP status could be associated with increased risk of peripheral neuropathy in T2DM patients.
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Naqvi et al. (2019) conducted a meta-analysis in Type 2 diabetes mellitus with and without peripheral neuropathy (n=355,438). Systolic blood pressure (SBP) and low-density lipoprotein (LDL) levels vs. T2DM patients with diabetic peripheral neuropathy was evaluated on Difference in systolic blood pressure (SBP) levels between T2DM patients without and with diabetic peripheral neuropathy (SMD -2.63, 95% CI -4.00 - -1.27, p=<0.001). In patients with type 2 diabetes, lower systolic blood pressure levels were significantly associated with the absence of diabetic peripheral neuropathy (SMD -2.63).
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