Attah Fredrick Andrew, Asaleye Christianah Mopelola, Omisore Adeleye Dorcas, Kolawole Babatope Ayodeji, Aderibigbe Adeniyi Sunday, Alo Mathew
Department of Radiology, Obafemi Awolowo University Teaching Hospitals Complex, Osun 220222, Nigeria.
Department of Radiology, Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals Complex, Osun 220222, Nigeria.
World J Diabetes. 2019 Jan 15;10(1):47-56. doi: 10.4239/wjd.v10.i1.47.
Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.
To evaluate the cross-sectional area (CSA) of the median nerve using B-mode ultrasonography (USS) and the presence of peripheral neuropathy (PN) in a cohort of adult diabetic Nigerians.
Demographic and anthropometric data of 85 adult diabetes mellitus (DM) and 85 age- and sex-matched apparently healthy control (HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument (MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile (FLP), fasting blood glucose (FBG) and glycated haemoglobin (HbA1c) while their MN CSA was evaluated at a point 5 cm proximal to (5cmCATL) and at the carpal tunnel (CATL) by high-resolution B-mode USS. Data was analysed using SPSS version 22.
The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5cmCATL ( < 0.01) and at the CATL ( < 0.01) on both sides. The presence of diabetic peripheral neuropathy (DPN) further increased the MN CSA at the CATL ( < 0.05) but not at 5cmCATL ( > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.
Thickening of the MN CSA at 5cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at 5cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.
神经病变是糖尿病常见的并发症，由高血糖对神经的直接损伤和/或供应神经的神经内膜血管微血管损伤导致的缺血引起。正中神经是糖尿病神经病变中常见受累的周围神经之一。在非尼日利亚糖尿病患者群体中对正中神经大小进行了研究。为了对现有文献有所贡献，需要在尼日利亚人群中开展一项研究。
使用B型超声（USS）评估成年尼日利亚糖尿病患者队列中正中神经的横截面积（CSA）以及周围神经病变（PN）的存在情况。
记录85例成年糖尿病（DM）患者和85例年龄及性别匹配的明显健康对照（HC）受试者的人口统计学和人体测量学数据。对所有研究对象进行全面体格检查以确定PN的存在情况，并使用改良的密歇根神经病变筛查工具（MNSI）对其严重程度进行分级。采集研究对象的静脉血用于检测空腹血脂谱（FLP）、空腹血糖（FBG）和糖化血红蛋白（HbA1c），同时通过高分辨率B型USS在距腕横纹近端5 cm处（5cmCATL）和腕管处（CATL）评估其正中神经CSA。使用SPSS 22版软件进行数据分析。
在5cmCATL处（P<0.01）和双侧CATL处（P<0.01），DM患者的平均正中神经CSA均显著厚于HC。糖尿病周围神经病变（DPN）的存在进一步增加了CATL处的正中神经CSA（P<0.05），但在5cmCATL处未增加（P>0.05）。然而，DPN的严重程度对距CATL近端5 cm处和CATL处的正中神经CSA没有额外影响。正中神经CSA与糖尿病病程及血糖控制之间无显著关联。
在糖尿病患者中可见5cmCATL处和CATL处正中神经CSA增厚。DPN的存在与CATL处正中神经CSA增厚更明显相关，但在5cmCATL处并非如此。DPN的严重程度、糖尿病病程和血糖控制对正中神经CSA没有额外影响。
