Mao Fei, Liu Siying, Qiao Xiaona, Zheng Hangping, Xiong Qian, Wen Jie, Liu Lianyong, Tang Mingming, Zhang Shuo, Zhang Zhaoyun, Ye Hongying, Lu Bin, Li Yiming
Department of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.
Department of Endocrinology and Metabolism, Jing'an District Center Hospital of Shanghai, Shanghai, China.
J Diabetes Investig. 2017 May;8(3):363-368. doi: 10.1111/jdi.12575. Epub 2016 Oct 5.
AIMS/INTRODUCTION: The aim of the present study was to use the sudomotor function test, Sudoscan, as a screening method for the evaluation of asymptomatic diabetic distal symmetric polyneuropathy in Chinese type 2 diabetes patients. As a result, more attention could be paid to those asymptomatic patients who could be easily neglected and underdiagnosed in everyday clinic.
A total of 394 Chinese type 2 diabetes patients were enrolled and tested for symptoms and clinical signs of neuropathy using the Neurological Symptom Score, Neuropathy Disability Score, and vibration perception threshold. Sudoscan was carried out, and the results were collected as the measurement of the electrochemical skin conductance of both hands and feet.
In the present study, we found that the abnormal rate of Sudoscan results in patients with asymptomatic neuropathy was higher than those without neuropathy and those with symptomatic neuropathy. This study also showed that lower electrochemical skin conductance at the feet was significantly associated with increasing symptoms, Neurological Symptom Score (r = -0.124, P < 0.05), Neuropathy Disability Score (r = -0.3, P < 0.01) and vibration perception threshold value (r = -0.18, P < 0.05). Logistic analysis showed that age (odds ratio 1.042, 95% confidence interval 1.014-1.071, P < 0.05) and feet electrochemical skin conductance levels (odds ratio 0.98, 95% confidence interval 0.962-0.993, P < 0.01) were independently associated with diabetic distal symmetric polyneuropathy.
Sudoscan might be a promising tool to screen asymptomatic diabetic distal symmetric polyneuropathy in Chinese patients with type 2 diabetes mellitus.
目的/引言：本研究的目的是使用汗腺功能测试（Sudoscan）作为一种筛查方法，来评估中国2型糖尿病患者的无症状性糖尿病远端对称性多发性神经病变。这样一来，在日常临床中，就能更多地关注那些容易被忽视和诊断不足的无症状患者。
共纳入394例中国2型糖尿病患者，使用神经症状评分、神经病变残疾评分和振动觉阈值对神经病变的症状和体征进行检测。进行Sudoscan检测，并收集双手和双脚的电化学皮肤传导率测量结果。
在本研究中，我们发现无症状神经病变患者的Sudoscan检测结果异常率高于无神经病变患者和有症状神经病变患者。本研究还表明，足部较低的电化学皮肤传导率与症状增加、神经症状评分（r = -0.124，P < 0.05）、神经病变残疾评分（r = -0.3，P < 0.01）和振动觉阈值（r = -0.18，P < 0.05）显著相关。逻辑分析显示，年龄（比值比1.042，95%置信区间1.014 - 1.071，P < 0.05）和足部电化学皮肤传导率水平（比值比0.98，95%置信区间0.962 - 0.993，P < 0.01）与糖尿病远端对称性多发性神经病变独立相关。
Sudoscan可能是筛查中国2型糖尿病患者无症状性糖尿病远端对称性多发性神经病变的一种有前景的工具。
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