Arterial stiffness is associated with small and large fiber neuropathy: The Maastricht Study

AIM: To examine the association between arterial stiffness as determined by carotid-femoral pulse wave velocity (cfPWV) and neuropathy (retinal, corneal, and peripheral). METHODS: We used population-based cross-sectional data from The Maastricht Study of N = 9188 participants (mean age 59.5 years, 50.2% women, 21% had type 2 diabetes) to study the associations between arterial stiffness and retinal nerve layer thickness, retinal sensitivity, corneal nerve measures, peripheral nerve conduction velocities, amplitudes, and vibration perception thresholds. We used linear regression analyses with adjustment for potential confounders and tested for interactions by sex and glucose metabolism status (prediabetes and type 2 diabetes vs. normal glucose metabolism), expressed as standardized betas. RESULTS: After adjustment, greater arterial stiffness was associated with lower Z scores for retinal nerve layer thickness [-0.04 (-0.07 to -0.00]), mean retinal sensitivity [-0.06 (-0.09 to -0.03)], corneal nerve measures [-0.05 (-0.09 to -0.01)], peripheral nerve conduction velocities [-0.05 (-0.08 to -0.03)], and tibial nerve amplitude [-0,05 (-0.08 to -0.01)], and higher Z scores for mean peripheral vibration perception thresholds [0.06 (0.03-0.08)]. In general, directionally similar associations were observed for all individual components. However, there was no significant association between the Z score for peroneal nerve amplitude [0.00 (-0.04 to 0.04)] and the Z score for sural nerve amplitude [0.00 (-0.04 to 0.03)]. The results were similar in men and women as well as in people across different glucose metabolism strata. CONCLUSION: Our findings show that arterial stiffening is associated with both small-fiber and large-fiber neuropathies. Further longitudinal research is needed to clarify whether arterial stiffening is a direct cause of neuropathy.