PT  - JOURNAL ARTICLE
AU  - Angela Beros
AU  - John Sluyter
AU  - Robert Keith Rhodes Scragg
TI  - Association of arterial stiffness and neuropathy in diabetes: a systematic review and meta-analysis
AID  - 10.1136/bmjdrc-2022-003140
DP  - 2023 Feb 01
TA  - BMJ Open Diabetes Research & Care
PG  - e003140
VI  - 11
IP  - 1
4099  - http://drc.bmj.com/content/11/1/e003140.short
4100  - http://drc.bmj.com/content/11/1/e003140.full
SO  - BMJ Open Diab Res Care2023 Feb 01; 11
AB  - Evidence is still emerging on the relationships of arterial stiffness with cardiac autonomic neuropathy (CAN) and peripheral neuropathy (PN). To our knowledge no systematic reviews or meta-analyses of these associations have been published. The purpose of our review was to assess the association of arterial stiffness with each type of neuropathy. Medline and Embase were systematically searched for observational studies of arterial stiffness and neuropathy.The systematic review of 60 studies (25 for CAN and 37 for PN), 59 including people with diabetes, showed arterial stiffness overall was higher in people with neuropathy than people without neuropathy. Forty-three studies were included in the meta-analysis. For CAN (19 studies), arterial stiffness was increased in people with neuropathy compared with without, as measured by pulse wave velocity (PWV) (mean difference: 1.32 m/s, 95% CI 0.82 to 1.81, p<0.00001), pulse pressure (PP) (mean difference: 6.25 mmHg, 95% CI 4.51 to 7.99, p<0.00001) or augmentation index (mean difference: 5.52%, 95% CI 3.46 to 7.58, p<0.0001). For PN (26 studies), arterial stiffness was increased in people with neuropathy compared with those without, as measured by PWV (mean difference: 1.22 m/s, 95% CI 0.87 to 1.58, p<0.00001) or PP (mean difference: 4.59 mmHg, 95% CI 2.96 to 6.22, p<0.00001). Only two cohort studies were located so the temporality of the association between arterial stiffness and neuropathy remains unclear. Increased arterial stiffness is associated with CAN and PN.PROSPERO registration number: CRD42019129563.All data relevant to the study are included in the article or uploaded as supplementary information.