Neuropathy Risk Influenced by Racial, Ethnic Disparities

TOPLINE:

Known risk factors for peripheral neuropathy (PN) may explain the higher prevalence of the condition in non-Hispanic Black adults but not in Hispanic adults in the US, a new study showed. Researchers found that other factors may drive the disparity, including social determinants of health, such as food insecurity and a high percentage of total caloric intake from saturated fatty acids.

METHODOLOGY:

• This cross-sectional secondary analysis included more than 8000 US adults (mean age, 61 years; 50% women) who participated in the National Health and Nutrition Examination Survey during 1999-2004.
• 55% of total participants were non-Hispanic White, 18% were non-Hispanic Black, 24% were Hispanic individuals, and 3% were of other races/ethnicities.
• Researchers assessed PN using a monofilament test for reduced sensation in both feet at three plantar locations: first metatarsal head, fifth metatarsal head, and the hallux.
• Demographic (age, sex, and race/ethnicity), metabolic (height, weight, waist circumference, systolic and diastolic blood pressure, and levels of high- and low-density lipoprotein cholesterol and A1c), and lifestyle (physical activity and diet) risk factors, as well as social determinants of health (food security, household income, and health insurance), were evaluated.

TAKEAWAY:

• Higher age- and sex-adjusted odds of PN were observed in both Black (odds ratio [OR], 1.39) and Hispanic (OR, 1.31) participants than in White participants. Additionally, men had a higher risk for PN than women after age and race adjustment — but not after comprehensive adjustment.
• After adjusting for metabolic, lifestyle, and social determinants of health factors, Hispanic individuals maintained a higher likelihood of having PN than White individuals (OR, 1.32; P = .001), while Black and White individuals had similar odds of having PN (OR, 1.17; P = .17).
• Lack of health insurance (OR, 1.49), older age (OR, 1.05), taller height (OR, 1.03), higher levels of A1c (OR, 1.13), and larger waist circumference (OR, 1.01) were all associated with an increased risk for PN.
• Among Hispanic individuals specifically, food insecurity (OR, 1.48) and increased percentage of total caloric intake from saturated fatty acids (OR, 1.06) were linked to increased PN risk.

IN PRACTICE:

“After comprehensively adjusting for known risk factors, we found that Black people had similar odds of neuropathy compared to White people, whereas Hispanic people continued to be at an increased likelihood of having neuropathy. Therefore, it is likely that unknown social risk factors exist for this population,” lead study author Evan Lee Reynolds, PhD, Michigan State University, East Lansing, Michigan, said in a press release.

Authors of an accompanying editorial added that the findings “are a call to action to continue to address the disproportionate exposure to modifiable risk factors in Black and Hispanic populations.” 

SOURCE:

The study and the accompanying editorial were published online on July 16 in Neurology. The editorial was authored by Georgette Dib and Nicholas E. Johnson, Virginia Commonwealth University, Richmond, Virginia.

LIMITATIONS: 

The study was retrospective, cross-sectional, and partly exploratory in nature and relied on self-reported data. Additionally, some data were missing, monofilament testing may have led to misclassification of PN, and assessment of triglyceride levels was performed only in 53% of participants. Study findings were not generalizable to other racial/ethnic groups or individuals with multiple races/ethnicities. 

DISCLOSURES:

Several investigators reported receiving funding from the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, Andrea and Lawrence A. Wolfe Research Professorship, Robert E. Nederlander Sr. Program for Alzheimer’s Research, Andrea and Lawrence A. Wolfe Brain Health Initiative Fund, A. Alfred Taubman Medical Research Institute, and the NeuroNetwork for Emerging Therapies. One investigator also reported consulting for DynaMed, receiving research and editorial support from the American Academy of Neurology, and providing medicolegal consultations. One of the editorialists reported having various ties with various sources, including pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.