Study of Risk Factors Diabetic Peripheral Neuropathy at One Single Center in Indonesia

Abstract

Background: Diabetes Mellitus (DM) is a disease that can lead to diabetic peripheral neuropathy (DPN). DPN is caused by various risk factors such as age, body mass index (BMI), glycated hemoglobin variability including mean HbA1c (M-HbA1c), hypertension status, triglyceride levels, total cholesterol levels, low-density lipoprotein (LDL) levels, and high-density lipoprotein (HDL) levels. This study aims to investigate the factors influencing DPN.Methods: A retrospective cross-sectional study of diabetic patients with and without DPN was undertaken at Jakarta referral hospitals from January 2021 to December 2022. Age, BMI, mean HbA1c variability, hypertension status, triglycerides, total cholesterol, LDL, and HDL values were compared between DPN and non-DPN groups. Chi-square analysis and logistic regression were performed to identify factors influencing DPN.Results: There were 62 patients diagnosed with DPN and 51 patients without DPN. Chi-square analysis showed a correlation between the variability of M-HbA1c (p = 0.003), triglycerides (p = 0.002), total cholesterol (p = 0.001), and LDL (p = 0.016) and the incidence of DPN in patients. Variability of M-HbA1c (p = 0.032, PR: 0.340, 0.127 – 0.914 95% CI), (p = 0.008, OR : 0.430, 0.205 – 0.793 95% CI), and HDL levels (p = 0.024, OR : 0.325, 0.122 – 0.865 95% CI) was revealed by logistic regression analysis.Conclusion: DPN correlates with a high degree of variability in M-HbA1c, triglyceride levels, total cholesterol, and LDL. Consequently, diabetics must monitor their respective health conditions in order to prevent DPN. AbstrakLatar belakang: Diabetes Mellitus (DM) merupakan penyakit yang dapat menyebabkan neuropati diabetik perifer (NDP). Neuropati diabetik perifer disebabkan oleh berbagai faktor risiko seperti usia, indeks massa tubuh (IMT), variabilitas HbA1c salah satunya rata-rata HbA1c (M-HbA1c), status hipertensi, kadar trigliserida, kadar kolesterol total, kadar low-density lipoprotein (LDL), dan kadar high-density lipoprotein (HDL). Penelitian ini untuk mengetahui faktor-faktor yang memengaruhi NDP.Metode: Penelitian potong-lintang retrospektif dengan melibatkan pasien DM dengan komplikasi neuropati diabetik perifer dan tidak di rumah sakit rujukan nasional di Jakarta, Indonesia pada Januari 2021 - Desember 2022. Perbandingan antara grup NDP dan tidak berdasarkan umur, IMT, Variabilitas rata-rata HbA1c, status hipertensi, trigliserida, kolesterol total, LDL, dan HDL. Analisis chi-square dan regresi logistik dilakukan untuk mengidentifikasi faktor-faktor mempengaruhi NDP.Hasil: 62 pasien datang dengan diagnosis NDP dan 51 pasien tanpa NDP. Analisis chi-square menyatakan terdapat hubungan signifikan antara variabilitas rata-rata HbA1c (p = 0,003), trigliserida (p = 0,002), kolesterol total (p = 0,001), dan LDL (p = 0,016) dengan kejadian NDP pasien. Analisis regresi logistik menunjukkan variabilitas rata-rata M-HbA1c (p = 0,032, OR: 0,340, 0,127 – 0,914 95% CI), kadar trigliserida (p = 0,008, OR : 0,430, 0,205 – 0,793 95% CI), dan kadar HDL (p = 0,024, OR : 0,325, 0,122 – 0,865 95% CI).Kesimpulan: Variabilitas M-HbA1c, kadar trigliserida, kolesterol total, LDL yang tinggi berkorelasi dengan NDP. dengan demikian, para penderita DM ini perlu selalu memantau kondisi kesehatan masing-masing agar tidak menimbulkan NDP.