Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis
Evidence is still emerging on the relationships of arterial stiffness with cardiac autonomic neuropathy (CAN) and peripheral neuropathy (PN). To our knowledge no systematic reviews or meta-analyses of these associations have been published. The purpose of our review was to assess the association of...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-02-01
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| Series: | BMJ Open Diabetes Research & Care |
| Online Access: | https://drc.bmj.com/content/11/1/e003140.full |
| _version_ | 1797791311247441920 |
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| author | Angela Beros John Sluyter Robert Keith Rhodes Scragg |
| author_facet | Angela Beros John Sluyter Robert Keith Rhodes Scragg |
| author_sort | Angela Beros |
| collection | DOAJ |
| description | Evidence is still emerging on the relationships of arterial stiffness with cardiac autonomic neuropathy (CAN) and peripheral neuropathy (PN). To our knowledge no systematic reviews or meta-analyses of these associations have been published. The purpose of our review was to assess the association of arterial stiffness with each type of neuropathy. Medline and Embase were systematically searched for observational studies of arterial stiffness and neuropathy.The systematic review of 60 studies (25 for CAN and 37 for PN), 59 including people with diabetes, showed arterial stiffness overall was higher in people with neuropathy than people without neuropathy. Forty-three studies were included in the meta-analysis. For CAN (19 studies), arterial stiffness was increased in people with neuropathy compared with without, as measured by pulse wave velocity (PWV) (mean difference: 1.32 m/s, 95% CI 0.82 to 1.81, p<0.00001), pulse pressure (PP) (mean difference: 6.25 mmHg, 95% CI 4.51 to 7.99, p<0.00001) or augmentation index (mean difference: 5.52%, 95% CI 3.46 to 7.58, p<0.0001). For PN (26 studies), arterial stiffness was increased in people with neuropathy compared with those without, as measured by PWV (mean difference: 1.22 m/s, 95% CI 0.87 to 1.58, p<0.00001) or PP (mean difference: 4.59 mmHg, 95% CI 2.96 to 6.22, p<0.00001). Only two cohort studies were located so the temporality of the association between arterial stiffness and neuropathy remains unclear. Increased arterial stiffness is associated with CAN and PN.PROSPERO registration number: CRD42019129563. |
| first_indexed | 2024-03-13T02:17:00Z |
| format | Article |
| id | doaj.art-68449617dcee4a52a81f5e8d9ef89531 |
| institution | Directory Open Access Journal |
| issn | 2052-4897 |
| language | English |
| last_indexed | 2024-03-13T02:17:00Z |
| publishDate | 2023-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Diabetes Research & Care |
| spelling | doaj.art-68449617dcee4a52a81f5e8d9ef895312023-06-30T12:00:06ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972023-02-0111110.1136/bmjdrc-2022-003140Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysisAngela Beros0John Sluyter1Robert Keith Rhodes Scragg2School of Population Health, University of Auckland, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New ZealandSchool of Population Health, University of Auckland, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New ZealandSchool of Population Health, University of Auckland, The University of Auckland Faculty of Medical and Health Sciences, Auckland, New ZealandEvidence is still emerging on the relationships of arterial stiffness with cardiac autonomic neuropathy (CAN) and peripheral neuropathy (PN). To our knowledge no systematic reviews or meta-analyses of these associations have been published. The purpose of our review was to assess the association of arterial stiffness with each type of neuropathy. Medline and Embase were systematically searched for observational studies of arterial stiffness and neuropathy.The systematic review of 60 studies (25 for CAN and 37 for PN), 59 including people with diabetes, showed arterial stiffness overall was higher in people with neuropathy than people without neuropathy. Forty-three studies were included in the meta-analysis. For CAN (19 studies), arterial stiffness was increased in people with neuropathy compared with without, as measured by pulse wave velocity (PWV) (mean difference: 1.32 m/s, 95% CI 0.82 to 1.81, p<0.00001), pulse pressure (PP) (mean difference: 6.25 mmHg, 95% CI 4.51 to 7.99, p<0.00001) or augmentation index (mean difference: 5.52%, 95% CI 3.46 to 7.58, p<0.0001). For PN (26 studies), arterial stiffness was increased in people with neuropathy compared with those without, as measured by PWV (mean difference: 1.22 m/s, 95% CI 0.87 to 1.58, p<0.00001) or PP (mean difference: 4.59 mmHg, 95% CI 2.96 to 6.22, p<0.00001). Only two cohort studies were located so the temporality of the association between arterial stiffness and neuropathy remains unclear. Increased arterial stiffness is associated with CAN and PN.PROSPERO registration number: CRD42019129563.https://drc.bmj.com/content/11/1/e003140.full |
| spellingShingle | Angela Beros John Sluyter Robert Keith Rhodes Scragg Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis BMJ Open Diabetes Research & Care |
| title | Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis |
| title_full | Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis |
| title_fullStr | Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis |
| title_full_unstemmed | Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis |
| title_short | Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis |
| title_sort | association of arterial stiffness and neuropathy in diabetes a systematic review and meta analysis |
| url | https://drc.bmj.com/content/11/1/e003140.full |
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