Metabolic syndrome in small fiber sensory neuropathy

OBJECTIVES: To determine the prevalence and risk of metabolic syndrome in patients with small fiber sensory neuropathy (SFSN). METHODS: We searched our skin biopsy database and identified 194 subjects for this retrospective study. Of these 194 subjects, 43 had normal skin biopsies and 151 had mild, moderate, or severe length-dependent SFSN with no large fiber involvement. Fifty-four subjects had diabetic or prediabetic SFSN and 97 had idiopathic SFSN. RESULTS: The mean age of the neuropathy group was older (54.1 ± 11.9 years) than the normal biopsy group (44.8 ± 13.0, P < 0.001). The prevalence of metabolic syndrome was higher in the neuropathy group (27.8%) than in the normal biopsy group (2.3%, P < 0.001). Age was not different among three neuropathy subgroups. The prevalence of metabolic syndrome was higher in the severe (38.1%) than in the moderate (26.0%) and mild (14.7%) neuropathy groups (P = 0.04). Multivariate analysis revealed that age (odds ratio [OR], 1.95; P < 0.001), metabolic syndrome (OR, 3.20; P < 0.001), hypertension (OR, 1.88; P = 0.04), and obesity (OR, 1.93; P = 0.004) were independent risk factors for SFSN. CONCLUSIONS: The prevalence of metabolic syndrome is increased in patients with SFSN and it correlates with the severity of SFSN. Metabolic syndrome may represent an independent risk factor for SFSN.