Neuropathy, nerve damage that causes pain and numbness in the feet and hands and can eventually lead to falls, infections and even amputations, is very common and underdiagnosed, according to a study published in the online edition of 8 May 2024 Neurology®the medical journal of the American Academy of Neurology.
“More than one-third of people with neuropathy experience sharp, stabbing, or shock-like pain, which increases their rates of depression and decreases quality of life,” said study author Melissa A. Elafros, MD, PhD. , from the University of Michigan. in Ann Arbor and a member of the American Academy of Neurology. “People with neuropathy are also at increased risk of premature death, even when taking into account other conditions they have, so identifying and treating people with or at risk of neuropathy is essential.”
The study involved 169 people from an internal medicine outpatient clinic that primarily serves Medicaid patients in Flint, Michigan. Participants had an average age of 58 years and 69% were black. Half of the people had diabetes, which can cause neuropathy. A total of 67% had metabolic syndrome, which is defined as having excess abdominal fat plus two or more of the following risk factors: high blood pressure, triglycerides (a type of fat found in the blood) higher than normal, normal, high blood sugar levels and low high-density lipoprotein (HDL) cholesterol, or “good” cholesterol. These risk factors are also associated with neuropathy.
All participants were evaluated for distal symmetric polyneuropathy. Information on other health conditions was also collected.
A total of 73% of people suffered from neuropathy. Of them, 75% had not previously been diagnosed with the condition. Almost 60% of people with neuropathy experienced pain.
Of those with neuropathy, 74% had metabolic syndrome, compared with 54% of those without neuropathy.
After adjusting for other factors that could affect the risk of neuropathy, the researchers found that people with metabolic syndrome were more than four times more likely to have neuropathy than people who did not have the syndrome.
The researchers also looked for any relationship between race, income and neuropathy, since few studies have been done on those topics. There was no relationship between low income and neuropathy. In terms of race, blacks had a lower risk of neuropathy. Blacks made up 60% of those with neuropathy and 91% of those without neuropathy.
“The number of people with neuropathy in this study, particularly undiagnosed neuropathy, was extraordinarily high: almost three-quarters of the study population,” Elafros said. “This highlights the urgent need for interventions that improve the diagnosis and treatment of this condition, as well as the need to manage the risk factors that can lead to this condition.” A limitation of the study is that it is a snapshot in time; did not follow people to see who developed neuropathy over time. It also did not look at reasons why people were unable to control the risk factors that can cause neuropathy.
The study was supported by the National Institute of Neurological Disorders and Stroke, the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Center for Advancing Translational Sciences.