Hypertension Contributes to Neuropathy in Patients With Type 1 Diabetes.
Action Potentials
Adult
Blood Pressure
Case-Control Studies
Cornea
/ innervation
Diabetes Mellitus, Type 1
/ complications
Diabetic Neuropathies
/ diagnosis
Female
Humans
Hypertension
/ complications
Male
Middle Aged
Nerve Fibers
/ pathology
Neural Conduction
Risk Factors
Tibial Nerve
/ physiopathology
Touch Perception
blood pressure
corneal confocal microscopy
diabetic peripheral neuropathy
hypertension
nerve conduction
quantitative sensory testing
Journal
American journal of hypertension
ISSN: 1941-7225
Titre abrégé: Am J Hypertens
Pays: United States
ID NLM: 8803676
Informations de publication
Date de publication:
17 07 2019
17 07 2019
Historique:
received:
26
01
2019
revised:
10
04
2019
accepted:
15
04
2019
pubmed:
24
4
2019
medline:
28
7
2020
entrez:
24
4
2019
Statut:
ppublish
Résumé
Diabetic peripheral neuropathy (DPN) can lead to foot ulceration and amputation. There are currently no disease-modifying therapies for DPN. The aim of this study was to determine if hypertension contributes to DPN in patients with type 1 diabetes mellitus (T1DM). Subjects with T1DM (n = 70) and controls (n = 78) underwent a comprehensive assessment of DPN. Hypertension was present in 40 of 70 T1DM subjects and 20 of 78 controls. Hypertension was associated with abnormal nerve conduction parameters (P = 0.03 to <0.001), increased vibration perception threshold (P = 0.01) and reduced corneal nerve fiber density and length (P = 0.02) in subjects with T1DM. However, after adjusting for confounding factors only tibial compound motor action potential and nerve conduction velocity were associated with hypertension (P = 0.03) and systolic blood pressure (P < 0.01 to <0.0001). Hypertension had no effect on neuropathy in subjects without diabetes. This study shows that hypertension is associated with impaired nerve conduction in T1DM. It supports previous small trials showing that angiotensin-converting enzyme inhibitors improve nerve conduction and advocates the need for larger clinical trials with blood pressure lowering agents in DPN.
Sections du résumé
BACKGROUND
Diabetic peripheral neuropathy (DPN) can lead to foot ulceration and amputation. There are currently no disease-modifying therapies for DPN. The aim of this study was to determine if hypertension contributes to DPN in patients with type 1 diabetes mellitus (T1DM).
METHODS
Subjects with T1DM (n = 70) and controls (n = 78) underwent a comprehensive assessment of DPN.
RESULTS
Hypertension was present in 40 of 70 T1DM subjects and 20 of 78 controls. Hypertension was associated with abnormal nerve conduction parameters (P = 0.03 to <0.001), increased vibration perception threshold (P = 0.01) and reduced corneal nerve fiber density and length (P = 0.02) in subjects with T1DM. However, after adjusting for confounding factors only tibial compound motor action potential and nerve conduction velocity were associated with hypertension (P = 0.03) and systolic blood pressure (P < 0.01 to <0.0001). Hypertension had no effect on neuropathy in subjects without diabetes.
CONCLUSIONS
This study shows that hypertension is associated with impaired nerve conduction in T1DM. It supports previous small trials showing that angiotensin-converting enzyme inhibitors improve nerve conduction and advocates the need for larger clinical trials with blood pressure lowering agents in DPN.
Identifiants
pubmed: 31013342
pii: 5477297
doi: 10.1093/ajh/hpz058
pmc: PMC6636691
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
796-803Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NINDS NIH HHS
ID : R01 NS046259
Pays : United States
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd.
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