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振动感觉阈值测量作为诊断糖尿病周围神经病变的一种方法的实用性:来自里约热内卢 2 型糖尿病队列研究的结果。

Usefulness of the vibration perception thresholds measurement as a diagnostic method for diabetic peripheral neuropathy: Results from the Rio de Janeiro type 2 diabetes cohort study.

机构信息

Department of Occupational Therapy, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Brazil.

Department of Internal Medicine, University Hospital Clementino Fraga Filho, School of Medicine, Universidade Federal do Rio de Janeiro, Brazil.

出版信息

J Diabetes Complications. 2018 Aug;32(8):770-776. doi: 10.1016/j.jdiacomp.2018.05.010. Epub 2018 Jun 18.

Abstract

AIMS

To investigate the associated factors with the vibration threshold perception (VPT) in patients with type 2 diabetes and to assess whether it is useful for detection of diabetic peripheral neuropathy (DPN).

METHODS

VPTs were measured with Vibration Sensory Analyzer (VSA-3000) in 426 diabetic patients. The diagnosis of DPN was based on Neuropathy Symptom Score and Neuropathy Disability Score (NDS). ROC curve analysis and multiple linear and logistic regressions were performed to investigate the associations between VPT and DPN.

RESULTS

Values of VPT were progressively higher according to NDS stages. Age, height, diabetes duration, and mean cumulative HbA exposure (partial correlation coefficients: 0.34; 0.27; 0.10; and 0.13; respectively) were the variables independently associated with VPT. Area under ROC curve of VPT for detection of DPN was 0.71 (95% CI: 0.66-0.75) and >8.9 μm was its best cut-off value. VPT, age, female sex, height, diabetes duration and mean HbA levels were the independent correlates of the presence of DPN. An increased VPT triplicate the likelihood of having DPN (OR: 3.24; 95% CI: 2.05-5.11).

CONCLUSIONS

VPT, measured by an automatic device, shares common correlates with DPN and is strongly associated with its presence. VPT testing may be useful as a screening tool for DPN assessment.

摘要

目的

调查 2 型糖尿病患者振动感觉阈值(VPT)的相关因素,并评估其对糖尿病周围神经病变(DPN)检测的作用。

方法

使用振动感觉分析仪(VSA-3000)对 426 例糖尿病患者进行 VPT 测量。DPN 的诊断基于神经病变症状评分和神经病变残疾评分(NDS)。进行 ROC 曲线分析和多元线性及逻辑回归,以研究 VPT 与 DPN 之间的关系。

结果

VPT 值随 NDS 分期逐渐升高。年龄、身高、糖尿病病程和平均累积 HbA 暴露(偏相关系数:0.34;0.27;0.10 和 0.13;分别)是与 VPT 独立相关的变量。VPT 检测 DPN 的 ROC 曲线下面积为 0.71(95%CI:0.66-0.75),最佳截断值为 8.9μm 以上。VPT、年龄、女性、身高、糖尿病病程和平均 HbA 水平是 DPN 存在的独立相关因素。VPT 增加三倍会增加 DPN 的可能性(OR:3.24;95%CI:2.05-5.11)。

结论

通过自动设备测量的 VPT 与 DPN 具有共同的相关因素,与 DPN 的存在密切相关。VPT 检测可能是评估 DPN 的一种有用的筛查工具。

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