Associations of polyneuropathy with risk of all‐cause and cardiovascular mortality, cardiovascular disease events stratified by diabetes status

AIMS/INTRODUCTION: We investigated the association of polyneuropathy (PN) with all‐cause and cardiovascular (CV) mortality and with cardiovascular disease (CVD) events stratified by diabetes status. MATERIALS AND METHODS: This prospective cohort study used the UK Biobank. Polyneuropathy was defined based on nurse‐led interviews or ICD codes for polyneuropathy. Cox proportional hazards models were used to investigate the association of polyneuropathy with clinical outcomes. RESULTS: A total of 459,127 participants were included in the analysis. Polyneuropathy was significantly associated with all‐cause and cardiovascular mortality, and with CVD events even after adjusting for CVD risk factors across all diabetes statuses. Metabolic parameters HbA(1c), waist circumference, BMI and the inflammatory parameter C‐reactive protein showed significant mediation effects for the association between polyneuropathy and CVD. Adherence to a favorable lifestyle was associated with a lower risk of all‐cause and cardiovascular mortality regardless of polyneuropathy status. CONCLUSIONS: Polyneuropathy was associated with all‐cause and cardiovascular mortality, and with CVD events in subjects with diabetes or prediabetes, even those having normal glucose tolerance. This study suggests the importance of polyneuropathy as a risk factor for death and highlights the necessity of early diagnosis and lifestyle intervention for those with type 2 diabetes and polyneuropathy.