Association between metabolic syndrome and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus: a cross-sectional study

Diabetic peripheral neuropathy (DPN) is the most prevalent chronic complication of diabetes. Several risk factors have been identified in recent studies, in particular metabolic syndrome (MetS). However, this association remains unclear. We aimed to determine the prevalence of DPN and to study its associated factors, especially the MetS as a potential risk factor of DPN in patients with Type 2 diabetes mellitus (T2DM). This was a retrospective and comparative study, with cross-sectional collected data, involving patients with T2DM from North Africa, followed up in the Department of Endocrinology-Diabetology-Nutrition at Mohammed VI University Hospital Center of Oujda, located in the eastern region of Morocco. Patients were grouped according to the presence (T2DM/DPN+, n = 110) or absence of DPN (T2DM/DPN-, n = 290). Data were collected from medical records and analyzed using SPSS software version 21. DPN was found in 27.5% of the patients. The mean age was similar between the two groups, at 58.96 ± 11.86 years in the T2DM/DPN+ group and 57.10 ± 13.29 years in the T2DM/DPN- group. Males comprised 40.9% of the T2DM/DPN+ group and 31.7% of the T2DM/DPN- group, but this difference was not statistically significant (p = 0.054). Patients with DPN had a significantly longer duration of diabetes (median 10 years vs. 5 years, p < 0.001). Both groups showed glycemic imbalance, with mean HbA1c values of 10.71 ± 2.31% for T2DM/DPN+ and 10.40 ± 2.87% for T2DM/DPN-, without a significant difference. MetS was a significant predictor of neuropathy presence. The prevalence of DPN was greater in individuals with hypertension (p = 0.013), abdominal obesity (p = 0.010), elevated triglyceride levels (p = 0.007), and low HDLc (p = 0.013). Male sex and the duration of diabetes were found to be significant risk factors for the development of DPN. MetS and its components are strongly associated with the presence of DPN in patients with T2DM. Therefore, screening and optimal control of these risk factors may help prevent DPN in these patients. However, further intervention studies are needed to determine whether comprehensive multifactorial control in patients with T2DM and MetS can effectively prevent DPN.