Are Hyperlipidemia and Lipid-Lowering Drugs Risk Factors for Diabetic Peripheral Neuropathy?

Abstract Aims Previous studies showed conflicting relationship between hyperlipidemia, lipid-lowering therapy and diabetic peripheral neuropathy (DPN). As most of these works emerges from the Western and Australian countries, our study aims to investigate whether hyperlipidemia or lipid-lowering drugs is associated with the risk of DPN in Taiwanese patients with type 2 diabetes (T2D). Methods A cross-sectional, hospital-based observation study in adults with T2D was conducted from January to October 2013. DPN was screened using the Michigan Neuropathy Screening Instrument. Diagnosis of hyperlipidemia was based on serum levels of lipid profiles. Patients taking lipid-lowering drugs were identified at enrollment. Results 2,448 participants were enrolled, 524 (21.4%) of whom had DPN. Patients with DPN had lower plasma total cholesterol (TC; 185.6 ± 38.6mg/dL vs 193.4 ± 42.3mg/dL, P < 0.001) and low-density lipoprotein cholesterol levels (LDL-C; 114.6 ± 32.7mg/dL vs 119 ± 30.8mg/dL, P = 0.019). Multivariate analysis demonstrated that neither hyperlipidemia nor lipid-lowering drugs was associated with a risk of DPN. Subgroup analysis revealed that high TC, LDL-C, and statin or fibrate use were not associated with DPN occurrence. Conclusion Our results suggests that neither hyperlipidemia nor lipid-lowering medication was associated with DPN in adults with T2D. DPN is a multifactorial disease, and our findings indicate that lipid metabolism may play a minor role in its pathogenesis.