Peripheral neuropathy associated with increased mortality risk, irrespective of diabetes status
Patients with both diabetes and peripheral neuropathy had the highest risk of death during the study's 13-year follow-up, but the next highest rate was in patients with peripheral neuropathy but no diabetes, followed by those with diabetes without peripheral neuropathy.
Peripheral neuropathy was associated with increased mortality risk in people with and without diabetes, a recent study found.
The prospective cohort study used data from the National Health and Nutrition Examination Survey on 7,116 adults ages 40 years or older who had standardized monofilament testing for peripheral neuropathy. It found an overall prevalence of neuropathy of 13.5%, 27.0% in those with diabetes and 11.6% in those without diabetes. During a median of 13 years of follow-up, 2,128 participants died, 488 of cardiovascular causes. Results were published by Annals of Internal Medicine on Dec. 8.
Mortality was increased with peripheral neuropathy: 57.6 per 1,000 person-years with both diabetes and peripheral neuropathy, 34.3 per 1,000 person-years with peripheral neuropathy but no diabetes, 27.1 per 1,000 person-years with diabetes but no peripheral neuropathy, and 13.0 per 1,000 person-years with neither condition. In adjusted models of patients with diabetes, peripheral neuropathy was significantly associated with all-cause mortality (hazard ratio [HR], 1.49; 95% CI, 1.15 to 1.94) and cardiovascular mortality (HR, 1.66; 95% CI, 1.07 to 2.57). In those without diabetes, the association of peripheral neuropathy with all-cause mortality was significant (HR, 1.31; 95% CI, 1.15 to 1.50), but the association with cardiovascular mortality was not (HR, 1.27; 95% CI, 0.98 to 1.66).
“Our study contributes to the growing body of literature supporting the concept that PN [peripheral neuropathy] is associated with substantial clinical sequelae,” the study authors said, adding that the findings show that “prevalence of PN among adults without diabetes is substantial and that PN may be an underrecognized risk factor for death.”