The association between hyperlipidemia, lipid-lowering drugs and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus

• Published in: PloS one 2023-06, Vol.18 (6), p.e0287373-e0287373
• Main Authors: Chang, Kuo-Cheng, Pai, Yen-Wei, Lin, Ching-Heng, Lee, I-Te, Chang, Ming-Hong
• Format: Article
• Language: English
• Subjects: Adult; Adults; Alcohol; Analysis; Australia; Biology and Life Sciences; Cardiovascular agents; Cardiovascular disease; Care and treatment; Cholesterol; Cross-Sectional Studies; Density; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes therapy; Diabetic neuropathies; Diabetic Neuropathies - complications; Diagnosis; Drug therapy; Gestational diabetes; Glucose; High density lipoprotein; Humans; Hyperglycemia; Hyperlipidemia; Hyperlipidemias - complications; Hypolipidemic Agents - adverse effects; Lipid metabolism; Lipids; Lipoproteins, LDL; Low density lipoproteins; Medical research; Medicine and Health Sciences; Medicine, Experimental; Metabolic disorders; Metabolism; Multivariate analysis; Pathogenesis; Peripheral neuropathy; Physiological aspects; Plasma; Review boards; Risk Factors; Statins; Subgroups; Type 2 diabetes; Variables
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0287373

Previous studies showed conflicting relationship between hyperlipidemia, lipid-lowering therapy and diabetic peripheral neuropathy (DPN). As most of these works emerges from the Western and Australian countries, our study aims to investigate whether hyperlipidemia or lipid-lowering therapy (LLT) is associated with DPN in Taiwanese patients with type 2 diabetes (T2D). A cross-sectional, hospital-based observation study in adults with T2D was conducted from January to October 2013. DPN was screened using the Michigan Neuropathy Screening Instrument. Data were obtained at the time of enrollment, including medication usage, anthropometric measurements and laboratory examinations. 2,448 participants were enrolled, 524 (21.4%) of whom had DPN. Patients with DPN had significantly lower plasma total cholesterol (185.6 ± 38.6 vs 193.4 ± 42.3 mg/dL) and low-density lipoprotein cholesterol levels (114.6 ± 32.7 vs 119 ± 30.8 mg/dL). Multivariate analysis demonstrated that neither hyperlipidemia (adjusted OR (aOR), 0.81; 95% confidence interval (CI), 0.49-1.34) nor LLT (aOR, 1.10; 95% CI, 0.58-2.09) was associated with DPN. Subgroup analysis revealed that neither total cholesterol (aOR, 0.72; 95% CI, 0.2-2.62), low-density lipoprotein cholesterol levels (aOR, 0.75; 95% CI, 0.2-2.79), statin (aOR, 1.09; 95% CI, 0.59-2.03) nor fibrate (aOR, 1.73; 95% CI, 0.33-1.61) was associated with DPN. Our results suggest that neither hyperlipidemia nor lipid-lowering medication was associated with DPN in adults with T2D. DPN is a multifactorial disease, and our findings indicate that lipid metabolism may play a minor role in its pathogenesis.