Abstract
We aimed to investigate the association of iron and polyunsaturated fatty acid (PUFA) intake with diabetic peripheral neuropathy (DPN) in individuals with type 2 diabetes. This cross-sectional study included 147 individuals with type 2 diabetes. Dietary intake was assessed using three-day food records. DPN was diagnosed on the basis of a Michigan Neuropathy Screening Instrument—Physical Examination score ≥2.5. Adjusted for total energy intake, iron intake was significantly higher in individuals with DPN than in those without DPN (10.9 ± 4.0 mg vs. 9.9 ± 3.6 mg, p = 0.041). In addition, the iron/PUFA ratio was significantly higher in individuals with DPN (1.4 ± 0.8 vs. 1.1 ± 0.4, p = 0.005). Logistic regression analyses showed that iron intake (odds ratio (OR): 1.152; 95% confidence interval (CI): 1.012, 1.311) and iron/PUFA ratio (OR: 2.283; 95% CI: 1.066, 4.887) were associated with DPN after adjustment for total energy intake, sex, age, body mass index, systolic blood pressure, diabetes duration, estimated glomerular filtration rate, glycated hemoglobin, low-density lipoprotein cholesterol, and smoking. In conclusion, high dietary iron intake and an elevated iron/PUFA ratio were associated with the presence of DPN. The present study suggests the importance of the dietary pattern of iron and PUFA intake in individuals with type 2 diabetes.
Highlights
Diabetic peripheral neuropathy (DPN) is the most common form of diabetic neuropathy [1].It is an important cause of foot ulceration and a major contributor to falls and fractures [2].Long-duration diabetes, old age, hyperglycemia, hypertension, dyslipidemia, obesity, alcohol, smoking, and insulin resistance are known risk factors for DPN [3,4]
Body mass index (BMI) and Homeostatic model assessment for insulin resistance (HOMA-IR) were numerically higher in individuals with DPN than in those without DPN, but the difference was not significant
Total cholesterol and low-density lipoprotein (LDL)–cholesterol levels were lower in individuals with DPN than in their counterparts without DPN
Summary
Diabetic peripheral neuropathy (DPN) is the most common form of diabetic neuropathy [1].It is an important cause of foot ulceration and a major contributor to falls and fractures [2].Long-duration diabetes, old age, hyperglycemia, hypertension, dyslipidemia, obesity, alcohol, smoking, and insulin resistance are known risk factors for DPN [3,4]. Diabetic peripheral neuropathy (DPN) is the most common form of diabetic neuropathy [1]. It is an important cause of foot ulceration and a major contributor to falls and fractures [2]. Long-duration diabetes, old age, hyperglycemia, hypertension, dyslipidemia, obesity, alcohol, smoking, and insulin resistance are known risk factors for DPN [3,4]. From a pathophysiologic point of view, oxidative stress is a key contributor to DPN [5]. Alpha-lipoic acid, a currently available antioxidant treatment, showed a clinically relevant effect on symptomatic DPN when administered by intravenous infusion [6]. There is no approved preventive or curative treatment for DPN other than risk factor management. The identification of additional modifiable factors is crucial for developing a new strategy to treat DPN
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