RT Journal Article
SR Electronic
T1 General and Abdominal Obesity and Incident Distal Sensorimotor Polyneuropathy: Insights Into Inflammatory Biomarkers as Potential Mediators in the KORA F4/FF4 Cohort
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 240
OP 247
DO 10.2337/dc18-1842
VO 42
IS 2
A1 Schlesinger, Sabrina
A1 Herder, Christian
A1 Kannenberg, Julia M.
A1 Huth, Cornelia
A1 Carstensen-Kirberg, Maren
A1 Rathmann, Wolfgang
A1 Bönhof, Gidon J.
A1 Koenig, Wolfgang
A1 Heier, Margit
A1 Peters, Annette
A1 Meisinger, Christa
A1 Roden, Michael
A1 Thorand, Barbara
A1 Ziegler, Dan
YR 2019
UL http://care.diabetesjournals.org/content/42/2/240.abstract
AB OBJECTIVE To investigate the associations between different anthropometric measurements and development of distal sensorimotor polyneuropathy (DSPN) considering interaction effects with prediabetes/diabetes and to evaluate subclinical inflammation as a potential mediator.RESEARCH DESIGN AND METHODS This study was conducted among 513 participants from the Cooperative Health Research in the Region of Augsburg (KORA) F4/FF4 cohort (aged 62–81 years). Anthropometry was measured at baseline. Incident DSPN was defined by neuropathic impairments using the Michigan Neuropathy Screening Instrument at baseline and follow-up. Associations between anthropometric measurements and DSPN were estimated by multivariable logistic regression. Potential differences by diabetes status were assessed using interaction terms. Mediation analysis was conducted to determine the mediation effect of subclinical inflammation in these associations.RESULTS After a mean follow-up of 6.5 years, 127 cases with incident DSPN were detected. Both general and abdominal obesity were associated with development of DSPN. The odds ratios (95% CI) of DSPN were 3.06 (1.57; 5.97) for overweight, 3.47 (1.72; 7.00) for obesity (reference: normal BMI), and 1.22 (1.07; 1.38) for 5-cm differences in waist circumference, respectively. Interaction analyses did not indicate any differences by diabetes status. Two chemokines (C-C motif chemokine ligand 7 [CCL7] and C-X-C motif chemokine ligand 10 [CXCL10]) and one neuron-specific marker (Delta/Notch-like epidermal growth factor–related receptor [DNER]) were identified as potential mediators, which explained a proportion of the total effect up to 11% per biomarker.CONCLUSIONS General and abdominal obesity were associated with incident DSPN among individuals with and without diabetes, and this association was partly mediated by inflammatory markers. However, further mechanisms and biomarkers should be investigated as additional mediators to explain the remainder of this association.