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Diabetic retinopathy as a predictor for peripheral compression neuropathies, a registry-based study

Olsson, Caroline ; Rydberg, Mattias LU orcid and Zimmerman, Malin LU orcid (2022) In PLoS ONE 17(10 October).
Abstract

Diabetes is characterized by hyperglycaemia and entails many complications, including retinopathy and entrapment neuropathies, such as ulnar nerve entrapment (UNE) and carpal tunnel syndrome (CTS). Hyperglycaemia damages the nerves of the retina, as well as peripheral nerves. There is a correlation between entrapment neuropathies and retinopathy in patients with diabetes, but whether patients with diabetic retinopathy are more prone to develop CTS and UNE is uncertain. Hence, the aim was to investigate if retinopathy can be used as a factor predicting the development of CTS and UNE. Data from 95,437 individuals from the National Diabetes Registry were merged with data from the Skåne Healthcare Registry. The population was analysed... (More)

Diabetes is characterized by hyperglycaemia and entails many complications, including retinopathy and entrapment neuropathies, such as ulnar nerve entrapment (UNE) and carpal tunnel syndrome (CTS). Hyperglycaemia damages the nerves of the retina, as well as peripheral nerves. There is a correlation between entrapment neuropathies and retinopathy in patients with diabetes, but whether patients with diabetic retinopathy are more prone to develop CTS and UNE is uncertain. Hence, the aim was to investigate if retinopathy can be used as a factor predicting the development of CTS and UNE. Data from 95,437 individuals from the National Diabetes Registry were merged with data from the Skåne Healthcare Registry. The population was analysed regarding prevalence of CTS or UNE and retinopathy status. Population characteristics were analysed using the Chi2-test, Student’s Independent T-test, and the Mann-Whitney U-test. Two logistic regression models were used to analyse the odds ratio (OR) for development of CTS and UNE depending on retinopathy status, adjusted for possible confounders. Both CTS and UNE were more frequent among those with retinopathy, compared to those without (CTS: 697/10,678 (6.5%) vs. 2756/83,151 (3.3%; p<0.001), (UNE: 131/10,678 (1.2%) vs. 579/83,151 (0.7%; p<0.001)). The OR for developing CTS for individuals with type 1 diabetes and retinopathy was 2.40 (95% CI 2.06–2.81; p<0.001) and of developing UNE was 1.53 (0.96–2.43; p = 0.08). The OR for developing CTS for individuals with type 2 diabetes and retinopathy was 0.93 (0.81–1.08; p = 0.34) and for UNE 1.02 (0.74–1.40; p = 0.90). Diabetic retinopathy is associated with a higher risk of developing CTS and UNE, but the association seems to be mediated by the duration of the diabetes. Higher HbA1c levels, longer diabetes duration and higher BMI are significant risk factors for developing CTS and UNE in type 1 and type 2 diabetes.

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type
Contribution to journal
publication status
published
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in
PLoS ONE
volume
17
issue
10 October
article number
e0275598
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:36227864
  • scopus:85139880605
ISSN
1932-6203
DOI
10.1371/journal.pone.0275598
language
English
LU publication?
yes
id
d76354c1-c14b-47dc-b5b2-a9b80bb95537
date added to LUP
2022-12-14 15:42:01
date last changed
2024-06-09 16:31:29
@article{d76354c1-c14b-47dc-b5b2-a9b80bb95537,
  abstract     = {{<p>Diabetes is characterized by hyperglycaemia and entails many complications, including retinopathy and entrapment neuropathies, such as ulnar nerve entrapment (UNE) and carpal tunnel syndrome (CTS). Hyperglycaemia damages the nerves of the retina, as well as peripheral nerves. There is a correlation between entrapment neuropathies and retinopathy in patients with diabetes, but whether patients with diabetic retinopathy are more prone to develop CTS and UNE is uncertain. Hence, the aim was to investigate if retinopathy can be used as a factor predicting the development of CTS and UNE. Data from 95,437 individuals from the National Diabetes Registry were merged with data from the Skåne Healthcare Registry. The population was analysed regarding prevalence of CTS or UNE and retinopathy status. Population characteristics were analysed using the Chi<sup>2</sup>-test, Student’s Independent T-test, and the Mann-Whitney U-test. Two logistic regression models were used to analyse the odds ratio (OR) for development of CTS and UNE depending on retinopathy status, adjusted for possible confounders. Both CTS and UNE were more frequent among those with retinopathy, compared to those without (CTS: 697/10,678 (6.5%) vs. 2756/83,151 (3.3%; p&lt;0.001), (UNE: 131/10,678 (1.2%) vs. 579/83,151 (0.7%; p&lt;0.001)). The OR for developing CTS for individuals with type 1 diabetes and retinopathy was 2.40 (95% CI 2.06–2.81; p&lt;0.001) and of developing UNE was 1.53 (0.96–2.43; p = 0.08). The OR for developing CTS for individuals with type 2 diabetes and retinopathy was 0.93 (0.81–1.08; p = 0.34) and for UNE 1.02 (0.74–1.40; p = 0.90). Diabetic retinopathy is associated with a higher risk of developing CTS and UNE, but the association seems to be mediated by the duration of the diabetes. Higher HbA1c levels, longer diabetes duration and higher BMI are significant risk factors for developing CTS and UNE in type 1 and type 2 diabetes.</p>}},
  author       = {{Olsson, Caroline and Rydberg, Mattias and Zimmerman, Malin}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{10 October}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Diabetic retinopathy as a predictor for peripheral compression neuropathies, a registry-based study}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0275598}},
  doi          = {{10.1371/journal.pone.0275598}},
  volume       = {{17}},
  year         = {{2022}},
}