Elif Börekci1, Adem Kara2, Mahmut Kılıç3, Nermin Tanık4, Zeynep T Ozan5, Tekin Yıldırım5, Yalçın Aral6. 1. Department of Internal Medicine, Celal Bayar University Faculty of Medicine, Uncubozköy, Yunus Emre, 45030, Manisa, Turkey. drelifg@hotmail.com. 2. Department of Internal Medicine, Yozgat State Hospital, Yozgat, Turkey. 3. Department of Public Health, Bozok University Faculty of Medicine, Yozgat, Turkey. 4. Department of Neurology, Bozok University Faculty of Medicine, Yozgat, Turkey. 5. Department of Internal Medicine, Bozok University Faculty of Medicine, Yozgat, Turkey. 6. Department of Endocrinology, Bozok University Faculty of Medicine, Yozgat, Turkey.
Abstract
PURPOSE: To investigate the relationship between the intensity of neuropathic pain and the severity of osteopenia in type 2 diabetic patients with painful diabetic peripheral neuropathy (painful DPN). METHODS: In 220 patients with type 2 diabetes included in the screening, the presence of neuropathic pain was evaluated using the Douleur Neuropathique 4 Questions (DN4) scoring system. One hundred forty-five patients with painful DPN were identified and included in the study. Socio-demographic and laboratory evaluations were made and bone mineral density (BMD) of these patients was evaluated by the dual-energy x-ray absorptiometry (DEXA) method. RESULTS: There was a significant correlation between the neuropathic pain score and the total T scores of the lumbar spine and femur in patients with painful DPN. According to the regression analysis (standard coefficients), the DN4 score (0.498); the level of vitamin D (- 0.246) and the female sex (0.236) for the lumbar spine region; age (0.387); DN4 score (0.261); and vitamin D level (- 0.155) for the femur region were independently influencing factors on the development of osteoporosis. When osteoporosis (T score ≤ - 2.5) of the lumbar spine was analyzed by binary logistic regression, the risk of osteoporosis in women was 4.4 times higher, and the risk increased with increasing DN4 score. CONCLUSION: The increase of neuropathic symptoms in patients with DPN is an effective and important factor in the development of diabetic osteopenia.
PURPOSE: To investigate the relationship between the intensity of neuropathic pain and the severity of osteopenia in type 2 diabeticpatients with painful diabetic peripheral neuropathy (painful DPN). METHODS: In 220 patients with type 2 diabetes included in the screening, the presence of neuropathic pain was evaluated using the Douleur Neuropathique 4 Questions (DN4) scoring system. One hundred forty-five patients with painful DPN were identified and included in the study. Socio-demographic and laboratory evaluations were made and bone mineral density (BMD) of these patients was evaluated by the dual-energy x-ray absorptiometry (DEXA) method. RESULTS: There was a significant correlation between the neuropathic pain score and the total T scores of the lumbar spine and femur in patients with painful DPN. According to the regression analysis (standard coefficients), the DN4 score (0.498); the level of vitamin D (- 0.246) and the female sex (0.236) for the lumbar spine region; age (0.387); DN4 score (0.261); and vitamin D level (- 0.155) for the femur region were independently influencing factors on the development of osteoporosis. When osteoporosis (T score ≤ - 2.5) of the lumbar spine was analyzed by binary logistic regression, the risk of osteoporosis in women was 4.4 times higher, and the risk increased with increasing DN4 score. CONCLUSION: The increase of neuropathic symptoms in patients with DPN is an effective and important factor in the development of diabetic osteopenia.
Entities:
Keywords:
Bone mineral density; Neuropathic pain score; Osteopenia; Painful diabetic peripheral neuropathy
Authors: Paola Castrogiovanni; Francesca Maria Trovato; Marta Anna Szychlinska; Houda Nsir; Rosa Imbesi; Giuseppe Musumeci Journal: Histol Histopathol Date: 2016-06-17 Impact factor: 2.303