The following is a summary of “Prevalence and Risk Factors of Distal Symmetric Polyneuropathy Among Predominantly Non-Hispanic Black, Low-Income Patients,” published in the May 2024 issue of Neurology by Elafros et al.
Researchers conducted a retrospective study addressing the knowledge gap regarding the prevalence, risk factors, and disease burden of Distal Symmetric Polyneuropathy (DSP) in underrepresented populations, specifically people who were non-Hispanic Black and individuals with low income.
They involved patients over 40 from a Flint, Michigan clinic catering mainly to Medicaid recipients. Data on demographics, clinical features, medication usage, physical measurements, lipid levels, and A1c were gathered. The modified Toronto Clinical Neuropathy Score (mTCNS) diagnosed DSP. Multivariable logistic regression analyzed DSP and undiagnosed cases, considering age, metabolic syndrome, and race. DSP burden was assessed through the Peripheral Neuropathy Quality of Life Instrument–97.
The results showed that of 200 participants, 169 (85%) completed all data collection. The population comprised 55% females with a mean age (SD) of 58.2 years (10.4), and 69% were non-Hispanic Black. Among them, 50% had diabetes, 67% had metabolic syndrome, and 47% had a household income <$20,000. DSP was present in 73% of the population, with 75% previously undiagnosed. Neuropathic pain was noted in 57% of those with DSP. DSP, as per mTCNS criteria, correlated with older age (OR 1.1 [95% CI 1.03–1.2]) and metabolic syndrome (OR 4.4 [1.1–18.1]). Participants who were non-Hispanic Black had lower odds of DSP (OR 0.1 [0.01–0.4]) compared to non-Hispanic whites and Hispanics. DSP burden was high, with increased pain, health-related worry, and poorer quality of life (all P<0.001).
Investigators concluded that DSP was highly prevalent and underdiagnosed in this low-income, predominantly on population with non-Hispanic Black, with metabolic syndrome emerging as a modifiable risk factor for lowering DSP prevalence.