内脏和皮下脂肪对周围神经病变的不同影响

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY

Journal of the Peripheral Nervous System Pub Date : 2025-05-09 DOI:10.1111/jns.70025

Georgios Ponirakis, Leeza Peerzada, Ioannis N. Petropoulos, Hoda Gad, Sidra Abdulshakoor, Jenneth M. Concepcion, Sara H. Khalfalla, Iynas S. A. Elamin, Abeer T. H. AlZawqari, Einas Elgassim, Areej Baraka, Ziyad R. Mahfoud, Marwa A. El Deeb, Nahla Afifi, Rayaz A. Malik

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引用次数: 0

摘要

肥胖增加糖尿病性神经病变的风险。本研究探讨了内脏（VAT）和皮下脂肪组织（SAT）体积对周围神经病变的影响。方法来自卡塔尔生物银行（QBB）的302名成年人接受iDXA测量VAT和SAT体积、内膜中膜厚度（IMT），并使用角膜共聚焦显微镜（CCM）、振动感知阈值（VPT）和DN4问卷进行周围神经病变评估。结果QBB队列患者年龄43.9±12.9岁，其中女性43.7%，肥胖42.1%，2型糖尿病（T2D） 17.4%，高血压10.9%。VAT与T2D、高血压、较高的HbA1c、舒张压、甘油三酯和炎症标志物以及较低的HDL相关（p < 0.0001）。SAT和这些心血管危险因素之间没有明显的关联。VAT容积与角膜下神经环长（IWL）（p < 0.05）和VPT升高（p = 0.01）相关，部分由HbA1c升高（p < 0.05, p = 0.001）和IMT升高（p < 0.0001）介导，而与神经病变症状的相关性由收缩压（p < 0.05）、T2D （p < 0.01）和甘油三酯（p = 0.05）完全介导。SAT与神经病变的测量没有关联。结论VAT与周围神经病变相关，而SAT与周围神经病变无关。这项研究强调了靶向VAT以改善神经病变的必要性。

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Differential Effects of Visceral and Subcutaneous Adiposity on Peripheral Neuropathy

Objective

Obesity increases the risk of diabetic neuropathy. This study investigates the impact of visceral (VAT) and subcutaneous adipose tissue (SAT) volume on peripheral neuropathy.

Methods

A total of 302 adults from the Qatar Biobank (QBB) underwent iDXA to measure VAT and SAT volumes, intima media thickness (IMT), and peripheral neuropathy assessments using corneal confocal microscopy (CCM), vibration perception threshold (VPT), and the DN4 questionnaire.

Results

The QBB cohort was aged 43.9 ± 12.9 years, of whom 43.7% were women, 42.1% had obesity, 17.4% had type 2 diabetes (T2D) and 10.9% had hypertension. VAT was associated with T2D, hypertension, higher HbA1c, diastolic blood pressure, triglycerides, and inflammatory markers, and lower HDL (p < 0.0001). There were no significant associations between SAT and these cardiovascular risk factors. VAT volume was associated with lower corneal nerve inferior whorl length (IWL) (p < 0.05) and higher VPT (p = 0.01), partially mediated by elevated HbA1c (p < 0.05, p = 0.001) and IMT (p < 0.0001), while its association with neuropathic symptoms was fully mediated by systolic blood pressure (p < 0.05), T2D (p < 0.01), and triglycerides (p = 0.05). SAT showed no associations with measures of neuropathy.

Conclusions

VAT but not SAT is associated with peripheral neuropathy. This study underscores the need to target VAT to improve neuropathy.

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来源期刊

Journal of the Peripheral Nervous System 医学-临床神经学

CiteScore

6.10

自引率

7.90%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of the Peripheral Nervous System is the official journal of the Peripheral Nerve Society. Founded in 1996, it is the scientific journal of choice for clinicians, clinical scientists and basic neuroscientists interested in all aspects of biology and clinical research of peripheral nervous system disorders. The Journal of the Peripheral Nervous System is a peer-reviewed journal that publishes high quality articles on cell and molecular biology, genomics, neuropathic pain, clinical research, trials, and unique case reports on inherited and acquired peripheral neuropathies. Original articles are organized according to the topic in one of four specific areas: Mechanisms of Disease, Genetics, Clinical Research, and Clinical Trials. The journal also publishes regular review papers on hot topics and Special Issues on basic, clinical, or assembled research in the field of peripheral nervous system disorders. Authors interested in contributing a review-type article or a Special Issue should contact the Editorial Office to discuss the scope of the proposed article with the Editor-in-Chief.