Arterial Stiffness Is Associated with Peripheral Sensory Neuropathy in Diabetes Patients in Ghana

Abstract

Objective. Peripheral sensory neuropathy (PSN) is among microvascular complications of diabetes that make patients prone to ulceration and amputation. Arterial stiffness is a predictor of cardiovascular diseases and microvascular complications associated with diabetes. We investigated the association between PSN and arterial stiffness, measured as aortic pulse wave velocity (PWVao) and cardio-ankle vascular index (CAVI). Method. In a case-control design, arterial stiffness was measured in 240 diabetes patients and 110 nondiabetic control. Large-fibre nerve function was assessed by vibration perception threshold (VPT) using a neurothesiometer. PSN was defined as the VPT > 97.5th percentile from age- and gender-adjusted models in nondiabetic controls. Results. The overall prevalence of PSN was 16.6% in the entire study participants. Compared to non-PSN participants, PSN patients had higher levels of PWVao (9.5 ± 1.7 versus 8.7 ± 1.2 m/s, p=0.016) and CAVI (8.4 ± 1.3 versus 7.6 ± 1.1, p=0.001). In multiple regression models, VPT was associated with PWVao (β=0.14, p=0.025) and CAVI (β=0.12, p=0.04). PSN patients had increased odds of CAVI (OR = 1.51 (1.02–2.4), p=0.043), but not PWVao (OR = 1.25 (0.91–1.71), p=0.173). Conclusion. PWVao and CAVI were associated with VPT and PSN in diabetes patients in Ghana. Patients having PSN have increased odds of CAVI, independent of other conventional risk factors.