Risk Factors for Developing Diabetic Peripheral Neuropathy: a Meta-analysis
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MEDICINE
Risk Factors for Developing Diabetic Peripheral Neuropathy: a Meta-analysis Tirzah M. Fakkel 1,2
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& Nuray Çakici & J. Henk Coert & Arianne P. Verhagen & Wichor M. Bramer & Johan W. van Neck
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Accepted: 20 August 2020 # The Author(s) 2020
Abstract To identify risk factors for the development of diabetic peripheral neuropathy, systematic searches of PubMed, Embase, Web-ofScience, Cochrane and Google scholar databases were performed to conduct a meta-analysis of prospective studies that quantified major risk factors for diabetic peripheral neuropathy. Two authors independently extracted data for a random-effects metaanalysis. The standardized mean difference (SMD) and 95% CI for continuous data, and an odds ratio (OR) and 95% CI for dichotomous data were calculated. Of 7473 studies retrieved, 16 qualified studies were included. Contributing risk factors for developing diabetic peripheral neuropathy were age (SMD = 0.36; CI, 0.19 to 0.54; P < 0.01), body mass index (SMD = 0.31; CI, 0.20 to 0.42; P < 0.01), diabetes duration (SMD = 0.47; CI, 0.30 to 0.65; P < 0.01), estimated glomerular filtration rate (SMD = − 0.45; CI, − 0.63 to − 0.27; P < 0.01), fibrinogen (SMD = 0.10; CI, 0.01 to 0.19; P = 0.03), haemoglobin A1c (SMD = 0.24; CI, 0.16 to 0.32; P < 0.01), high-density lipoproteins (SMD = − 0.14; CI, − 0.21 to − 0.06; P < 0.01) systolic blood pressure (SMD = 0.31; CI, 0.10 to 0.52; P < 0.01), waist circumference (SMD = 0.39; CI, 0.14 to 0.64; P < 0.01), weight (SMD = 0.34; CI, 0.24 to 0.43; P < 0.01), cardiovascular disease (OR = 2.22; CI, 1.75 to 2.81; P < 0.01), foot ulcer history (OR = 1.90; CI, 1.09 to 3.33; P = 0.02), hypertension (OR = 1.90; CI, 1.24 to 2.89; P < 0.01), macroalbuminuria (OR = 2.96; CI, 2.02 to 4.35; P < 0.01), microor macroalbuminuria (OR = 1.73; CI, 1.43 to 2.08; P < 0.01), proliferative retinopathy (OR = 2.48; CI, 1.80 to 3.41; P < 0.01) and retinopathy (OR = 2.19; CI, 1.84 to 2.62; P < 0.01). Our findings show 17 risk factors that significantly contribute to the development of diabetic peripheral neuropathy. Keywords Diabetic neuropathy . Diabetic foot . Risk factors . Meta-analysis
Introduction
Tirzah M. Fakkel and Nuray Çakici contributed equally to this work. This article is part of the Topical Collection on Medicine Electronic supplementary material The online version of this article (https://doi.org/10.1007/s42399-020-00480-0) contains supplementary material, which is available to authorized users. * Tirzah M. Fakkel [email protected] 1
Department of Plastic and Reconstructive Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
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Department of Plastic-, Reconstructive- and Hand Surgery, Utrecht University Medical Center, Utrecht, The Netherlands
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Department of Physiotherapy, University of Technology Sydney, Sydney, Australia
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Department of Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands
Diabetic peripheral neuropathy (DPN) is a frequently occurring chronic complication in people with diabetes [1–5
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