Carotid atherosclerosis ups risk of small fibre nerve dysfunction in T2D

Among patients with type 2 diabetes (T2D), the presence of carotid atherosclerosis appears to aggravate the risk of developing small fibre nerve dysfunction (SFD), a recent study has found.

Researchers enrolled 247 patients with T2D who had undergone ultrasonography. Patients were also assessed through quantitative sensory testing, including warm and cold detection thresholds, to determine the presence of SFD. Participants were also grouped into four: non-carotid atherosclerosis, carotid intimal thickening, unilateral carotid atherosclerosis, and bilateral carotid atherosclerosis.

More than half (58.3 percent; n=144) of patients developed SFD. Its prevalence rate was significantly higher in patients with carotid atherosclerosis (72.2 percent; p<0.001), especially those with bilateral carotid atherosclerosis (81.7 percent; p<0.001).

Compared to patients without SFD, the carotid intima-media thickness was higher in SFD patients (p=0.018) as was the size of the atherosclerotic plaque (p<0.001). In addition, SFD patients saw lower cold detection (p<0.001) and higher warm detection (p<0.001) and heat pain (p<0.001) thresholds.

Logistic regression analysis confirmed these findings and showed that carotid atherosclerosis increased the likelihood of SFD by more than two times (odds ratio [OR], 2.326; p=0.017). This effect was much stronger for bilateral atherosclerosis, which aggravated SFD risk by more than five times (OR, 5.042; p=0.001).

The findings suggest “that in clinical practice, for patients with T2D or patients with cardiovascular complications, it is important to pay more attention to small fibre nerve function for the early prevention, detection, and intervention of SFN,” the researchers said.

“Further prospective studies and possibly multicentre studies with wide racial and ethnicity participation are required to confirm these findings,” they added.