Study on the relation between diabetic neuropathy and atherosclerotic cardiovascular disease

Abstract

The global prevalence of diabetes is still on the rise and has reached 573 million individuals. This population has cardiovascular mortality twice that observed in patients without diabetes, and risk of up to 30% of developing diabetic sensorimotor neuropathy (DSPN). DSPN shares pathophysiologic mechanisms related to the progression of atherosclerotic disease. Therefore, it is possible that the clinical evaluation of patients with DSPN may help to identify patients at higher risk of atherosclerotic cardiovascular disease. Nevertheless, this hypothesis remains unexplored in our population. Methods: Cross-sectional study with data collected by the Brazilian Diabetes Study (BDS) national prospective cohort. Individuals aged 40-70 years underwent assessment for DSPN by the Michigan Neuropathy Screening Instrument. Based on this examination, participants will be grouped according to the presence or absence of DSPN. In turn, the cardiovascular disease will be defined by: (I) previous occurrence of the events: acute myocardial infarction, coronary artery bypass grafting, stroke; (II) carotid atherosclerosis, defined by carotid Doppler ultrasound with measurement of mid-intimal thickness or plaque; (III) coronary calcium score greater than zero. The primary objective is to determine the relationship between the presence of DSPN and the occurrence of CVD. Secondary objectives are: (I) to assess the prevalence and risk factors of DSPN in our population; (II) to explore the relation between DSPN and CVD severity, estimated by IMT values and calcium score; (III) to explore the association between DSPN and the occurrence of diabetic retinopathy and nephropathy.(AU)