Examination of a cross sectional association between intake levels of the antioxidant vitamins E, C, and B6 and diabetic peripheral neuropathy

Objective:

The objective of this study was to determine if there is a cross sectional association between intake of the antioxidant vitamins E, C and B₆ and diabetic peripheral neuropathy (DPN), a severe complication of long term diabetes with multiple negative consequences, using data from a nationally representative survey.

Methods:

Aggregate data from the 1999-2001 National Health and Nutrition Examination Survey (NHANES) was used for the data analysis. The sample was limited to participants with diagnosed diabetes age 40 and older who had answered the question on DPN. Antioxidant vitamin intake levels were based on a 24 hour food recall interview and measured by converting nutrient values from consumed foods. A logistic regression model was fit to the data to determine if there was a significant relation between the 3 antioxidant vitamins and DPN.

Results:

Of the 3 antioxidant vitamins examined (vitamins C, E, and B6), only vitamin B₆ was significantly related to DPN (OR 0.84, 95% CI 0.7-1.0). Along with vitamin B6, age, insulin use, presence of retinopathy, and the interaction between insulin and retinopathy were associated with DPN. Insulin use was significant among participants with retinopathy (OR 3.4, 95% CI 1.88-6.15) but not among those without retinopathy (OR 1.48, 95% CI 0.8-2.7).

Conclusions:

The presence of vitamin B₆ was found to be protective for DPN. This finding is noteworthy and future work should focus on more quantifiable measures of vitamins such as serum or plasma levels and their relation to either prevention or treatment of DPN.