Medial arterial calcification and diabetic neuropathy |
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Authors: | Sandro Gentile Antonio Bizzarro Riccardo Marmo Annamaria de Bellis Cosimo Orlando |
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Institution: | (1) Istituto di Medicina Generale e Metodologia Clinica, I Facoltà di Medicina, Università di Napoli, Napoli;(2) Cattedra di Patologia Speciale Medica e Metodologia Clinica, I Facoltà di Medicina, Università di Napoli, Napoli, Italy |
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Abstract: | Summary The aim of this study was to detect linear arterial calcification (M?nckeberg’s sclerosis) localized in feet, ankles, legs,
knees and hands in an attempt to correlate the extent of calcification with the presence and severity of autonomic neuropathy
as well as with microangiopathy (proliferative retinopathy, proteinuria >200 mg/die) and peripheral neuropathy. Typical linear calcification were observed in 37 out of 41 (90.2%) patients with autonomic neuropathy
and in none of those without autonomic neuropathy (p<0.001). These 37 patients were divided into two subgroups by cluster
analysis: Subgroup A, including 18 subjects with calcification length ranging from 8 to 26 cm and moderate autonomic neuropathy,
and Subgroup B, including 19 subjects with calcification length between 58 and 126 cm and severe autonomic neuropathy (p<0.0001
by Spearman’s test). No difference in the length of arterial calcification was detected between patients with proteinuria
>200 mg/24h and/or proliferative retinopathy and patients without these complications. A possible relationship between arterial
calcification and peripheral neuropathy is difficult to evaluate; in fact, the majority of subjects having autonomic neuropathy
had peripheral neuropathy, too. Vice versa, around 10% of patients without peripheral neuropathy but with autonomic neuropathy
did not have M?nckeberg’s sclerosis. Autonomic neuropathy is the principal factor responsible for calcification of the arterial
media, and in addition the severity of the neuropathy, rather than the patient’s age or the known disease duration seems to
determine the extent of calcification. |
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Keywords: | Autonomic neuropathy M?nckenberg’ s sclerosis |
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