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Can both normal and mildly abnormal albuminuria and glomerular filtration rate be a danger signal for diabetic peripheral neuropathy in type 2 diabetes mellitus?

Neurological Sciences volume 38, pages 1381–1390 (2017)Cite this article

Abstract

We aimed to investigate the potential association between urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) and diabetic peripheral neuropathy (DPN). We were especially interested in the relationship between normal or mildly abnormal UACR and eGFR with DPN. A retrospective study was performed in 1059 patients with type 2 diabetes patients from Fuzhou, China, who were seen between 2010 and 2015. The DPN population demonstrated higher UACR and lower eGFR than the non-DPN population. Nerve conduction velocities (NCVs) were negatively correlated with UACR and were positively correlated with eGFR. UACR and eGFR were associated with the risk of DPN. Even in the UACR < 30 mg/g and eGFR ≥ 60 ml/min/1.73 m2 groups, the relationship above still existed and patients in the highest tertiles of UACR and lowest tertiles of eGFR demonstrated a greater risk of DPN (OR = 2.456, 95% CI 1.461–4.127; OR = 2.021, 95% CI 1.276–3.203). Receiver operating characteristic (ROC) analysis revealed that the area under curve (AUC) of UACR, eGFR, and joints indicates that DPN was 0.749, 0.662, and 0.731, respectively. Lower eGFR and higher UACR may be associated with the risk of DPN, even though normal or mildly abnormal UACR and eGFR have already been found to be predictive factors of DPN. Further, UACR is more sensitive than eGFR. Separately, UACR was a moderate indication of DPN, and combining it with eGFR did not increase its effect of indication to DPN.

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  1. Department of Endocrinology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, Fujian, 350005, China

    Yongze Zhang, Ying Jiang, Ximei Shen & Sunjie Yan

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  1. Yongze Zhang
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Sunjie Yan conducted the design of the study and reviewed/edited the drafts, and is guarantor. Yongze Zhang researched data and edited the drafts and contributed to discussion. Ying Jiang wrote manuscript. Ximei Shen cowrote the final draft.

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Correspondence to Sunjie Yan.

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Zhang, Y., Jiang, Y., Shen, X. et al. Can both normal and mildly abnormal albuminuria and glomerular filtration rate be a danger signal for diabetic peripheral neuropathy in type 2 diabetes mellitus?. Neurol Sci 38, 1381–1390 (2017). https://doi.org/10.1007/s10072-017-2946-1

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  • DOI: https://doi.org/10.1007/s10072-017-2946-1

Keywords

  • Type 2 diabetes mellitus
  • Diabetic peripheral neuropathy
  • Urinary albumin-to-creatinine ratio
  • Estimated glomerular filtration rate