Skip to main content
Top
Published in: Obesity Surgery 3/2019

01-03-2019 | Original Contribution

Polyneuropathy in Severely Obese Women Without Diabetes: Prevalence and Associated Factors

Authors: Lisiane Stefani Dias, Otto Henrique Nienov, Fernanda Dapper Machado, Camila Perlin Ramos, Daiane Rodrigues, Rodrigo Koprovsky Menguer, Helena Schmid

Published in: Obesity Surgery | Issue 3/2019

Login to get access

Abstract

Background

Obesity and its complications are prevalent in women and increase with age. Polyneuropathy (PNP) is a complication of obesity and bariatric surgery (BS). In subjects with severe (grades II and III) obesity and without DM who are candidates for BS, the prevalence of PNP and associated conditions are not well characterized. The aim of this study was to evaluate the prevalence of PNP in severely obese (SO) women without DM or common nutritional deficiencies in order to determine factors associated with the presence of PNP.

Methods

A cross-sectional study was performed on 450 SO women. They were evaluated with the Michigan Neuropathy Screening Instrument, a Sleep Apnea Questionnaire, and the short form of the International Physical Activity Questionnaire. Data on blood pressure, body mass index, waist circumference, serum glucose, glycated hemoglobin, LDL and HDL cholesterol, triglycerides, vitamin B12, and postmenopausal (PM) status were also collected. Patients with DM and other common causes of PNP were excluded. To evaluate which variables were independently associated with PNP (dependent variable), Poisson regression models were used.

Results

The prevalence of PNP was 11.6%. In univariate analysis, PNP was associated with age, PM status, and diagnosis of systemic arterial hypertension (p < 0.001, p < 0.001, and p = 0.016, respectively), and there was a trend toward an association with sleep apnea risk (p = 0.101). In multivariate analysis, PM status (PR = 2.836, 95% CI 1.735–4.636, p = 0.001) and age (PR = 1.0511, 95% CI 1.031–1.071, p = 0.001) were independently associated with PNP diagnosis in two different models.

Conclusion

Even prior to BS, PNP is highly prevalent and is associated with PM status and age in SO women without diabetes.
Literature
1.
go back to reference Pop-Busui R, Boulton AJM, Feldman EL, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136–54.CrossRefPubMed Pop-Busui R, Boulton AJM, Feldman EL, et al. Diabetic neuropathy: a position statement by the American Diabetes Association. Diabetes Care. 2017;40(1):136–54.CrossRefPubMed
2.
3.
4.
go back to reference Ylitalo KR, Sowers M, Heeringa S. Peripheral vascular disease and peripheral neuropathy in individuals with cardiometabolic clustering and obesity: national health and nutrition examination survey 2001-2004. Diabetes Care. 2011;34:1642–7.CrossRefPubMedPubMedCentral Ylitalo KR, Sowers M, Heeringa S. Peripheral vascular disease and peripheral neuropathy in individuals with cardiometabolic clustering and obesity: national health and nutrition examination survey 2001-2004. Diabetes Care. 2011;34:1642–7.CrossRefPubMedPubMedCentral
5.
go back to reference Nienov OH, Matte L, Dias LS, et al. Peripheral polyneuropathy in severely obese patients with metabolic syndrome but without diabetes: association with low HDL-cholesterol. Rev Assoc Med Bras. 2017;63(4):324–31.CrossRefPubMed Nienov OH, Matte L, Dias LS, et al. Peripheral polyneuropathy in severely obese patients with metabolic syndrome but without diabetes: association with low HDL-cholesterol. Rev Assoc Med Bras. 2017;63(4):324–31.CrossRefPubMed
6.
go back to reference Callaghan BC, Xia R, Reynolds E, et al. Association between metabolic syndrome components and polyneuropathy in an obese population. JAMA Neurol. 2016;73(12):1468–76.CrossRefPubMedPubMedCentral Callaghan BC, Xia R, Reynolds E, et al. Association between metabolic syndrome components and polyneuropathy in an obese population. JAMA Neurol. 2016;73(12):1468–76.CrossRefPubMedPubMedCentral
8.
go back to reference Ziegler D, Rathmann W, Dickhaus T, et al. Prevalence of polyneuropathy in pre-diabetes and diabetes is associated with abdominal obesity and macroangiopathy: the MONICA/KORA Augsburg surveys S2 and S3. Diabetes Care. 2008;31(3):464–9.CrossRefPubMed Ziegler D, Rathmann W, Dickhaus T, et al. Prevalence of polyneuropathy in pre-diabetes and diabetes is associated with abdominal obesity and macroangiopathy: the MONICA/KORA Augsburg surveys S2 and S3. Diabetes Care. 2008;31(3):464–9.CrossRefPubMed
9.
go back to reference Suzuki S, Brown CM, Wise PM. Mechanisms of neuroprotection by estrogen. Endocrine. 2006;29(2):209–15.CrossRefPubMed Suzuki S, Brown CM, Wise PM. Mechanisms of neuroprotection by estrogen. Endocrine. 2006;29(2):209–15.CrossRefPubMed
10.
go back to reference Teede HJ, Lombard C, Deeks AA. Obesity, metabolic complications and the menopause: an opportunity for prevention. Climacteric. 2010;13(3):203–9.CrossRefPubMed Teede HJ, Lombard C, Deeks AA. Obesity, metabolic complications and the menopause: an opportunity for prevention. Climacteric. 2010;13(3):203–9.CrossRefPubMed
11.
go back to reference WHO. Overweight and obesity: World Health Organization; 2017. WHO. Overweight and obesity: World Health Organization; 2017.
12.
go back to reference Menguer RK, Weston AC, Schmid H. Evaluation of metabolic syndrome in morbidly obese patients submitted to laparoscopic bariatric surgery: comparison of the results between roux-En-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2017;27(7):1719–23.CrossRefPubMed Menguer RK, Weston AC, Schmid H. Evaluation of metabolic syndrome in morbidly obese patients submitted to laparoscopic bariatric surgery: comparison of the results between roux-En-Y gastric bypass and sleeve gastrectomy. Obes Surg. 2017;27(7):1719–23.CrossRefPubMed
13.
go back to reference Herman WH, Pop-Busui R, Braffett BH, et al. Use of the Michigan neuropathy screening instrument as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: results from the diabetes control and complications trial/epidemiology of diabetes interventions and complications. Diabet Med. 2012;29(7):937–44.CrossRefPubMedPubMedCentral Herman WH, Pop-Busui R, Braffett BH, et al. Use of the Michigan neuropathy screening instrument as a measure of distal symmetrical peripheral neuropathy in type 1 diabetes: results from the diabetes control and complications trial/epidemiology of diabetes interventions and complications. Diabet Med. 2012;29(7):937–44.CrossRefPubMedPubMedCentral
14.
go back to reference Pardini R, Matsudo S, Matsudo V, et al. Validação do questionário internacional de nível de atividade física (IPAQ - versão 6): estudo piloto em adultos jovens brasileiros. Rev Bras Ciên e Mov. 2001;9(3):45–51. Pardini R, Matsudo S, Matsudo V, et al. Validação do questionário internacional de nível de atividade física (IPAQ - versão 6): estudo piloto em adultos jovens brasileiros. Rev Bras Ciên e Mov. 2001;9(3):45–51.
15.
go back to reference Fonseca LB de M, Silveira EA, Lima NM, et al. STOP-Bang questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol. 2016;42(4):266–72.CrossRef Fonseca LB de M, Silveira EA, Lima NM, et al. STOP-Bang questionnaire: translation to Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol. 2016;42(4):266–72.CrossRef
16.
go back to reference Oliveira FB, Botelho KK, Bezerra AR, et al. Cross-cultural adaptation to Brazilian Portuguese of the Michigan neuropathy screening instrument: MNSI-Brazil. Arq Neuropsiquiatr. 2016;74(8):653–61.CrossRefPubMed Oliveira FB, Botelho KK, Bezerra AR, et al. Cross-cultural adaptation to Brazilian Portuguese of the Michigan neuropathy screening instrument: MNSI-Brazil. Arq Neuropsiquiatr. 2016;74(8):653–61.CrossRefPubMed
17.
go back to reference National Institutes of Health State-of-the-Science Conference statement. Management of menopause-related symptoms. Ann Intern Med. 2005;142(12):1003–13. National Institutes of Health State-of-the-Science Conference statement. Management of menopause-related symptoms. Ann Intern Med. 2005;142(12):1003–13.
18.
go back to reference Cheng YJ, Gregg EW, Kahn HS, et al. Peripheral insensate neuropathy: a tall problem for US adults? Am J Epidemiol. 2006;164(9):873–80.CrossRefPubMed Cheng YJ, Gregg EW, Kahn HS, et al. Peripheral insensate neuropathy: a tall problem for US adults? Am J Epidemiol. 2006;164(9):873–80.CrossRefPubMed
19.
go back to reference Maser RE, Steenkiste AR, Dorman JS, et al. Epidemiological correlates of diabetic neuropathy. Report from Pittsburgh epidemiology of diabetes complications study. Diabetes. 1989;38(11):1456–61.CrossRefPubMed Maser RE, Steenkiste AR, Dorman JS, et al. Epidemiological correlates of diabetic neuropathy. Report from Pittsburgh epidemiology of diabetes complications study. Diabetes. 1989;38(11):1456–61.CrossRefPubMed
20.
go back to reference Franklin GM, Shetterly SM, Cohen JA, et al. Risk factors for distal symmetric neuropathy in NIDDM. The San Luis Valley Diabetes Study. Diabetes Care. 1994;17(10):1172–7.CrossRefPubMed Franklin GM, Shetterly SM, Cohen JA, et al. Risk factors for distal symmetric neuropathy in NIDDM. The San Luis Valley Diabetes Study. Diabetes Care. 1994;17(10):1172–7.CrossRefPubMed
21.
go back to reference Russell JW, Feldman EL. Impaired glucose tolerance - does it cause neuropathy? Muscle Nerve. 2001;24(9):1109–12.CrossRefPubMed Russell JW, Feldman EL. Impaired glucose tolerance - does it cause neuropathy? Muscle Nerve. 2001;24(9):1109–12.CrossRefPubMed
22.
go back to reference Callaghan BC, Xia R, Banerjee M, et al. Metabolic syndrome components are associated with symptomatic polyneuropathy independent of glycemic status. Diabetes Care. 2016;39(5):801–7.CrossRefPubMedPubMedCentral Callaghan BC, Xia R, Banerjee M, et al. Metabolic syndrome components are associated with symptomatic polyneuropathy independent of glycemic status. Diabetes Care. 2016;39(5):801–7.CrossRefPubMedPubMedCentral
23.
go back to reference Smith AG, Russell J, Feldman EL, et al. Lifestyle intervention for pre-diabetic neuropathy. Diabetes Care. 2006;29(6):1294–9.CrossRefPubMed Smith AG, Russell J, Feldman EL, et al. Lifestyle intervention for pre-diabetic neuropathy. Diabetes Care. 2006;29(6):1294–9.CrossRefPubMed
24.
25.
go back to reference Dziewas R, Schilling M, Engel P, et al. Treatment for obstructive sleep apnoea: effect on peripheral nerve function. J Neurol Neurosurg Psychiatry. 2006;78(3):295–7.CrossRefPubMedPubMedCentral Dziewas R, Schilling M, Engel P, et al. Treatment for obstructive sleep apnoea: effect on peripheral nerve function. J Neurol Neurosurg Psychiatry. 2006;78(3):295–7.CrossRefPubMedPubMedCentral
Metadata
Title
Polyneuropathy in Severely Obese Women Without Diabetes: Prevalence and Associated Factors
Authors
Lisiane Stefani Dias
Otto Henrique Nienov
Fernanda Dapper Machado
Camila Perlin Ramos
Daiane Rodrigues
Rodrigo Koprovsky Menguer
Helena Schmid
Publication date
01-03-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-03627-0

Other articles of this Issue 3/2019

Obesity Surgery 3/2019 Go to the issue