Pan Qi, Li Quanmin, Deng Wei, Zhao Dong, Qi Lin, Huang Wei, Ma Li, Li Hongmei, Li Yufeng, Lyu Xiaofeng, Wang Aihong, Yao Hebin, Xing Xiaoyan, Guo Lixin
Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Beijing, China.
Department of Endocrinology, General Hospital of the PLA Rocket Force, Beijing, China.
Front Endocrinol (Lausanne). 2018 Nov 5;9:617. doi: 10.3389/fendo.2018.00617. eCollection 2018.
Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes, and its progression significantly worsens the patient's quality of life. This study investigated the prevalence and risk factors associated with DPN in a large sample of Beijing individuals with type 1 and 2 diabetes, as well as compared the diagnostic methods for DPN. A total of 2,048 diabetic patients from 13 centers in Beijing were assessed for DPN through questionnaires and examination. Patients were divided into DPN group and suspected DPN/non-DPN group. The demographic, clinical and biological characteristics between the two groups were compared. Binary logistic regression analysis was performed to identify potential variables associated with DPN in diabetic patients. The diagnostic methods for DPN were also compared. Among the 2,048 diabetic patients, 73 cases of type 1 diabetes mellitus, 1,975 cases of type 2 diabetes were included in this study. Among them, 714 (34.86%) were identified with DPN, 537 (26.22%) were suspected of having DPN, and 797 (38.92%) were identified without DPN. Patient's age, duration of diabetes, and diabetic retinopathy were the significant independent risk factor for DPN among patients with type 2 diabetes. The odds ratio (OR) was 1.439 (95% confidence interval (CI): 1.282-1.616, < 0.001), 1.297 (95% CI: 1.151-1.462, < 0.001), and 0.637 (95% CI: 0.506-0.802, < 0.001), respectively. Ankle reflex, temperature sensation plus vibration sensation are the best screening test for patients with type 1 and 2 diabetes. The Youden indexes were 62.2 and 69.8%, respectively. The prevalence rates of DPN in the Chinese patients with type 1 and type 2 diabetes in Beijing were 21.92 and 35.34%, respectively. Patient's age, duration of diabetes, and diabetic retinopathy are the independent risk factors for DPN.
糖尿病周围神经病变（DPN）是糖尿病最常见的并发症，其进展会显著恶化患者的生活质量。本研究调查了北京大量1型和2型糖尿病患者中DPN的患病率及相关危险因素，并比较了DPN的诊断方法。通过问卷调查和检查对来自北京13个中心的2048例糖尿病患者进行了DPN评估。患者被分为DPN组和疑似DPN/非DPN组。比较了两组之间的人口统计学、临床和生物学特征。进行二元逻辑回归分析以确定糖尿病患者中与DPN相关的潜在变量。还比较了DPN的诊断方法。在这2048例糖尿病患者中，本研究纳入了73例1型糖尿病患者、1975例2型糖尿病患者。其中，714例（34.86%）被确诊为DPN，537例（26.22%）疑似患有DPN，797例（38.92%）被确诊无DPN。患者年龄、糖尿病病程和糖尿病视网膜病变是2型糖尿病患者发生DPN的显著独立危险因素。比值比（OR）分别为1.439（95%置信区间（CI）：1.282 - 1.616，P < 0.001）、1.297（95%CI：1.151 - 1.462，P < 0.001）和0.637（95%CI：0.506 - 0.802，P < 0.001）。踝反射、温度觉加振动觉是1型和2型糖尿病患者最佳的筛查试验。约登指数分别为62.2%和69.8%。北京1型和2型糖尿病中国患者中DPN的患病率分别为21.92%和35.34%。患者年龄、糖尿病病程和糖尿病视网膜病变是DPN的独立危险因素。
