Chahal Simran, Vohra Kanchan, Syngle Ashit
Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India.
Healing Touch City Clinic, # 547, Sector 16-D, Chandigarh, 160015, India.
Neurol Sci. 2017 Jan;38(1):151-156. doi: 10.1007/s10072-016-2742-3. Epub 2016 Oct 25.
Peripheral artery disease (PAD) is the major risk factor for cardiovascular disease and lower extremity amputation in patients with diabetes. Autonomic neuropathy is a risk factor for cardiovascular-related morbidity and mortality. Sudomotor dysfunction is well established in type 2 diabetes mellitus (T2DM) and reflects small fibre neuropathy, cardiovascular autonomic neuropathy and peripheral sympathetic autonomic neuropathy. However, the relationship between sudomotor dysfunction and PAD remains unexplored. Therefore, the aim of present study was to explore the association of sudomotor function with ankle-brachial index (ABI) and C-reactive protein (CRP) in T2DM. In this cross-sectional study, we recruited 36 consecutive type 2 diabetes patients and 20 age- and sex-matched healthy controls. Sudomotor function was assessed using Sudoscan (Sudoscan-Impeto Medical Device, EZS 01750010193, Paris, France), which detects sweat gland function through measurement of electrochemical skin conductance of both hands and feet. Measurement of ankle-brachial ABI was carried out with sphygmomanometer and Doppler device (Hadeco Bidop ES-100V3). Glycated haemoglobin (HbA1c), fasting plasma glucose, and inflammatory marker CRP were also measured. Type 2 diabetic patients had significantly impaired sudomotor function (48.14 ± 8.28 vs. 76.48 ± 6.72 µs), lower ABI (0.89 ± 0.25 vs. 1.15 ± 0.11) and elevated CRP (5.32 ± 2.41 vs. 2.45 ± 1.11 mg/l) as compared to healthy controls, respectively (p < 0.01). Sudoscan scores were found to be inversely correlated with CRP and HbA1c, and directly correlated with ABI (p < 0.05) in the patients. Sudomotor dysfunction is associated with significant peripheral artery disease, vascular inflammation and impaired glycaemic status.
外周动脉疾病（PAD）是糖尿病患者心血管疾病和下肢截肢的主要危险因素。自主神经病变是心血管相关发病率和死亡率的危险因素。泌汗功能障碍在2型糖尿病（T2DM）中已得到充分证实，反映了小纤维神经病变、心血管自主神经病变和外周交感自主神经病变。然而，泌汗功能障碍与PAD之间的关系仍未得到探索。因此，本研究的目的是探讨T2DM患者泌汗功能与踝臂指数（ABI）和C反应蛋白（CRP）之间的关联。在这项横断面研究中，我们连续招募了36例2型糖尿病患者和20例年龄及性别匹配的健康对照者。使用Sudoscan（Sudoscan-Impeto医疗设备，EZS 01750010193，法国巴黎）评估泌汗功能，该设备通过测量双手和双脚的电化学皮肤电导率来检测汗腺功能。使用血压计和多普勒设备（Hadeco Bidop ES-100V3）测量踝臂ABI。还测量了糖化血红蛋白（HbA1c）、空腹血糖和炎症标志物CRP。与健康对照者相比，2型糖尿病患者的泌汗功能明显受损（48.14±8.28对76.48±6.72μs），ABI较低（0.89±0.25对1.15±0.11），CRP升高（5.32±2.41对2.45±1.11mg/l）（p<0.01）。在患者中，发现Sudoscan评分与CRP和HbA1c呈负相关，与ABI呈正相关（p<0.05）。泌汗功能障碍与严重的外周动脉疾病、血管炎症和血糖状态受损有关。
