Strotmeyer Elsa S, de Rekeneire Nathalie, Schwartz Ann V, Faulkner Kimberly A, Resnick Helaine E, Goodpaster Bret H, Shorr Ronald I, Vinik Aaron I, Harris Tamara B, Newman Anne B
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Diabetes Care. 2008 Sep;31(9):1767-72. doi: 10.2337/dc08-0433. Epub 2008 Jun 5.
Poor peripheral nerve function is prevalent in diabetes and older populations, and it has great potential to contribute to poor physical performance.
Cross-sectional analyses were done for the Health, Aging, and Body Composition (Health ABC) Study participants (n = 2,364; 48% men; 38% black; aged 73-82 years). Sensory and motor peripheral nerve function in legs/feet was assessed by 10- and 1.4-g monofilament perception, vibration detection, and peroneal motor nerve conduction amplitude and velocity. The Health ABC lower-extremity performance battery was a supplemented version of the Established Populations for the Epidemiologic Studies of the Elderly battery (chair stands, standing balance, and 6-m walk), adding increased stand duration, single foot stand, and narrow walk.
Diabetic participants had fewer chair stands (0.34 vs. 0.36 stands/s), shorter standing balance time (0.69 vs. 0.75 ratio), slower usual walking speed (1.11 vs. 1.14 m/s), slower narrow walking speed (0.80 vs. 0.90 m/s), and lower performance battery score (6.43 vs. 6.93) (all P < 0.05). Peripheral nerve function was associated with each physical performance measure independently. After addition of peripheral nerve function in fully adjusted models, diabetes remained significantly related to a lower performance battery score and slower narrow walking speed but not to chair stands, standing balance, or usual walking speed.
Poor peripheral nerve function accounts for a portion of worse physical performance in diabetes and may be directly associated with physical performance in older diabetic and nondiabetic adults. The impact of peripheral nerve function on incident disability should be evaluated in older adults.
外周神经功能不佳在糖尿病患者和老年人群中普遍存在，并且极有可能导致身体机能下降。
对健康、衰老与身体成分（Health ABC）研究的参与者（n = 2364；48%为男性；38%为黑人；年龄73 - 82岁）进行横断面分析。通过10克和1.4克单丝触觉、振动觉检测以及腓总运动神经传导幅度和速度来评估下肢/足部的感觉和运动外周神经功能。Health ABC下肢机能测试组合是对老年人流行病学研究既定人群测试组合（从椅子上站起、站立平衡和6米步行）的补充版本，增加了站立持续时间、单脚站立和窄道步行测试。
糖尿病参与者从椅子上站起的次数较少（0.34次/秒对0.36次/秒），站立平衡时间较短（比例为0.69对0.75），平常步行速度较慢（1.11米/秒对1.14米/秒），窄道步行速度较慢（0.80米/秒对0.90米/秒），并且机能测试组合得分较低（6.43对6.93）（所有P < 0.05）。外周神经功能与各项身体机能指标均独立相关。在完全调整模型中加入外周神经功能因素后，糖尿病仍与较低的机能测试组合得分以及较慢的窄道步行速度显著相关，但与从椅子上站起的次数（从椅子上站起、站立平衡或平常步行速度）无关。
外周神经功能不佳是糖尿病患者身体机能较差的部分原因，并且可能与老年糖尿病患者和非糖尿病成年人的身体机能直接相关。应在老年人中评估外周神经功能对发生残疾的影响。
