Diabetes Center, 2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
Diabetes Center, 1st Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, ''AHEPA'' Hospital, Thessaloniki, Greece.
Curr Vasc Pharmacol. 2020;18(5):517-522. doi: 10.2174/1570161117666190723155324.
Sudomotor dysfunction is a feature of Diabetic Peripheral Neuropathy (DPN). The indicator plaster Neuropad can provide an easy and accurate way to diagnose DPN. The aim of the present study was to evaluate Neuropad's specificity, sensitivity and accuracy in detecting DPN in patients with Diabetes Mellitus (DM).
A total of 174 patients with DM (79 with type 1 DM, 88 women), mean age 49.8 ± 16.1 years and mean DM duration 17.3 ± 7.7 years were included in the present study. The following methods were used to diagnose DPN: the Michigan Neuropathy Screening Instrument Questionnaire and Examination (MNSIQ and MNSIE, respectively), application of 10 g monofilament (MONO) and measurement of vibration perception threshold with biothesiometer (BIO). Neuropad was applied to both feet in all patients and according to the presence or absence of color change of the sticker, patients were divided in two groups: group A (n = 82, complete change in color from blue to pink, depicting normal perspiration) and group B (n = 92, incomplete or no change, depicting abnormal perspiration).
MNSIQ and MNSIE were positive for DPN in 111 and 119 patients, respectively. BIO was abnormal in 109 and MONO in 59 patients. Sensitivity of Neuropad testing was 95% vs. MONO, 73% vs. BIO, 73% vs. MNSIE and 75% vs. ΜNSIQ. Specificity was 69, 81, 90 and 92%, respectively and accuracy of the test was 78, 76, 78 and 83%, respectively.
Neuropad has a high sensitivity and specificity in detecting DPN vs. MNSIQ, MNSIE and BIO. Neuropad has a high sensitivity but moderate specificity vs. MONO. The accuracy of the test was high in all measurements.
出汗功能障碍是糖尿病周围神经病变（DPN）的特征。指示膏体 Neuropad 可以提供一种简单而准确的方法来诊断 DPN。本研究的目的是评估 Neuropad 在诊断糖尿病患者（DM）的 DPN 中的特异性、敏感性和准确性。
本研究共纳入 174 例糖尿病患者（1 型糖尿病 79 例，女性 88 例），平均年龄 49.8±16.1 岁，平均糖尿病病程 17.3±7.7 年。采用密歇根州周围神经病变筛查工具问卷和检查（MNSIQ 和 MNSIE）、10g 单丝（MONO）应用和生物感觉计（BIO）测量振动感觉阈值来诊断 DPN。所有患者的双脚均应用 Neuropad，并根据贴剂颜色变化的有无，将患者分为两组：A 组（n=82，贴剂完全从蓝色变为粉红色，提示正常出汗）和 B 组（n=92，部分或无变化，提示异常出汗）。
MNSIQ 和 MNSIE 对 DPN 阳性的患者分别为 111 例和 119 例。BIO 异常的患者为 109 例，MONO 异常的患者为 59 例。Neuropad 检测的敏感性分别为 95%与 MONO、73%与 BIO、73%与 MNSIE 和 75%与 MNSIQ。特异性分别为 69%、81%、90%和 92%，准确性分别为 78%、76%、78%和 83%。
Neuropad 检测 DPN 的敏感性和特异性均高于 MNSIQ、MNSIE 和 BIO。Neuropad 与 MONO 相比具有较高的敏感性和中等特异性。所有检测方法的准确性均较高。
