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胰岛素依赖型糖尿病患儿周围神经病变的患病率及相关危险因素

Prevalence and related risk-factors of peripheral neuropathy in children with insulin-dependent diabetes mellitus.

作者信息

Hasani Nasibeh, Khosrawi Saeid, Hashemipour Mahin, Haghighatiyan Mania, Javdan Zahra, Taheri Mohamad Hadi, Kelishadi Roya, Amini Massoud, Barekatein Reihaneh

机构信息

Department of Obstetrics and Gynecology, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Res Med Sci. 2013 Feb;18(2):132-6.

Abstract

BACKGROUND

Diabetes mellitus (DM) is a common metabolic disorder that can cause various complications including, peripheral neuropathy (PNP). Some possible risk-factors such as blood glucose level, hyperglycemia, duration of diabetes, and lipid profiles are assumed to be important in diabetic PNP incidence. The aim of this study is to evaluate the prevalence and possible risk-factors of PNP in children with insulin dependent DM.

MATERIALS AND METHODS

Among diabetic children, 146 patients (up to 18-years old) were evaluated in this cross-sectional study. All patients were examined for signs and symptoms of neuropathy and nerve conduction studies were performed. Blood level of glucose and lipid profiles were also tested. The relation between variables was compared by independent t-test and logistic regression test.

RESULTS

The mean age of diabetic children was 11.9 ± 3.3 years whereas mean diabetes duration was 3.8 ± 2.9 years. PNP was detected in 40 patients (27.4%) that 62.5% of them have subclinical and 37.5% have clinical neuropathy. According to logistic regression analysis, duration of diabetes was the most important factor in prevalence of PNP (5.7 ± 3.5 and 3.1 ± 2.5 years in patients with and without neuropathy respectively, P < 0.001, 95% confidence interval [1.15-1.54]).

CONCLUSION

As most of the patients had subclinical PN, neurological assessment is recommended to detect subclinical neuropathy in asymptomatic type 1 diabetic children and it seems that the best way to prevent this complication is still rigid blood glucose control and periodic evaluations.

摘要

背景

糖尿病(DM)是一种常见的代谢紊乱疾病,可导致包括周围神经病变(PNP)在内的各种并发症。一些可能的风险因素,如血糖水平、高血糖、糖尿病病程和血脂谱,被认为在糖尿病性PNP的发生中很重要。本研究的目的是评估胰岛素依赖型糖尿病儿童中PNP的患病率和可能的风险因素。

材料与方法

在这项横断面研究中,对146例糖尿病儿童患者(年龄最大18岁)进行了评估。所有患者均接受了神经病变的体征和症状检查,并进行了神经传导研究。还检测了血糖水平和血脂谱。通过独立t检验和逻辑回归检验比较变量之间的关系。

结果

糖尿病儿童的平均年龄为11.9±3.3岁,而平均糖尿病病程为3.8±2.9年。在40例患者(27.4%)中检测到PNP,其中62.5%为亚临床型,37.5%为临床神经病变。根据逻辑回归分析,糖尿病病程是PNP患病率的最重要因素(有神经病变和无神经病变的患者分别为5.7±3.5年和3.1±2.5年,P<0.001,95%置信区间[1.15-1.54])。

结论

由于大多数患者患有亚临床PN,建议对无症状的1型糖尿病儿童进行神经学评估以检测亚临床神经病变,并且似乎预防这种并发症的最佳方法仍然是严格控制血糖和定期评估。

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