Ylitalo Kelly R, Herman William H, Harlow Siobán D
Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA; Department of Internal Medicine, University of Michigan, 6108 Brehm Tower, Ann Arbor, MI 48105-5714, USA.
Prim Care Diabetes. 2013 Dec;7(4):309-13. doi: 10.1016/j.pcd.2013.07.001. Epub 2013 Jul 27.
To determine if diabetes or pre-diabetes is associated with monofilament insensitivity and peripheral neuropathy symptoms.
The 10-g Semmes-Weinstein monofilament test and Michigan Neuropathy Screening Instrument symptom questionnaire were administered to participants in the Study of Women's Health Across the Nation - Michigan site (n=396). We determined the concordance of monofilament insensitivity and symptoms and used chi-square tests, ANOVA, and logistic regression to quantify the relationships among diabetes status, monofilament insensitivity and symptoms.
The prevalence of monofilament insensitivity was 14.3% and 19.4% of women reported symptoms of peripheral neuropathy. With monofilament testing, 11.7% of women with normal fasting glucose, 14.4% of women with impaired fasting glucose (IFG) and 18.3% of women with diabetes had monofilament insensitivity (p-value=0.33). For symptoms, 14.0% of women with normal fasting glucose, 16.5% of women with IFG and 31.2% of women with diabetes reported symptoms of peripheral neuropathy. Women who reported symptoms of small fiber nerve dysfunction alone were unlikely to have monofilament insensitivity. Compared to women with normal fasting glucose, women with diabetes were more likely to report peripheral neuropathy symptoms [OR 2.8 (95% CI: 1.5, 5.1)]. Women with diabetes were also more likely to report symptoms than women with IFG (p=0.02). There was no difference in the frequency of symptoms between women with normal fasting glucose and IFG.
Women with diabetes were more likely to report peripheral neuropathy symptoms. The prevalence of monofilament insensitivity and peripheral neuropathy symptoms did not differ between women with normal fasting glucose and IFG.
确定糖尿病或糖尿病前期是否与单丝不敏感及周围神经病变症状相关。
对全国妇女健康研究密歇根站点的参与者(n = 396)进行10克Semmes-Weinstein单丝试验和密歇根神经病变筛查工具症状问卷评估。我们确定了单丝不敏感与症状的一致性,并使用卡方检验、方差分析和逻辑回归来量化糖尿病状态、单丝不敏感和症状之间的关系。
单丝不敏感的患病率为14.3%,19.4%的女性报告有周围神经病变症状。通过单丝测试,空腹血糖正常的女性中有11.7%、空腹血糖受损(IFG)的女性中有14.4%以及糖尿病女性中有18.3%存在单丝不敏感(p值 = 0.33)。对于症状,空腹血糖正常的女性中有14.0%、IFG女性中有16.5%以及糖尿病女性中有31.2%报告有周围神经病变症状。仅报告小纤维神经功能障碍症状的女性不太可能存在单丝不敏感。与空腹血糖正常的女性相比,糖尿病女性更有可能报告周围神经病变症状[比值比2.8(95%置信区间:1.5,5.1)]。糖尿病女性也比IFG女性更有可能报告症状(p = 0.02)。空腹血糖正常的女性和IFG女性之间的症状频率没有差异。
糖尿病女性更有可能报告周围神经病变症状。空腹血糖正常的女性和IFG女性之间单丝不敏感和周围神经病变症状的患病率没有差异。