前驱糖尿病、糖尿病、代谢综合征和小纤维神经病。

Prediabetes, diabetes, metabolic syndrome, and small fiber neuropathy.

机构信息

Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska.

College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska.

出版信息

Muscle Nerve. 2020 Apr;61(4):475-479. doi: 10.1002/mus.26825. Epub 2020 Feb 18.

DOI:10.1002/mus.26825

PMID:32012301

Abstract

INTRODUCTION

This study was conducted to evaluate the association between prediabetes (PD), elements of the metabolic syndrome (MetS), and small fiber neuropathy (SFN).

METHODS

A total of 268 patients with SFN symptoms and normal electrophysiology underwent tests to assess small fibers. SFN was diagnosed based on abnormality of at least two among intraepidermal nerve fiber density (IEFND), quantitative sensory testing, and quantitative sudomotor axon reflex testing.

RESULTS

There was no difference in IENFD or abnormal skin biopsy frequency between PD and normoglycemia (NG). However, IENFD was lower in people with diabetes mellitus (DM) than in those with NG. An association between HbA1C and IENFD was observed only if DM patients were included. Attributes of the MetS were more common in those with an abnormal skin biopsy but not among those with autonomic dysfunction or meeting SFN criteria.

DISCUSSION

DM, but not PD alone, is associated with SFN. Other MetS elements appear to preferentially impact small fiber structure over function.

摘要

简介

本研究旨在评估前驱糖尿病（PD）、代谢综合征（MetS）各元素与小纤维神经病（SFN）之间的关联。

方法

共 268 例有 SFN 症状和正常电生理学表现的患者接受了小纤维检测，SFN 的诊断基于至少两项异常，包括表皮内神经纤维密度（IEFND）、定量感觉测试和定量自主神经反射测试。

结果

PD 与血糖正常（NG）患者的 IENFD 或异常皮肤活检频率无差异。然而，与 NG 患者相比，糖尿病患者的 IENFD 更低。仅当纳入 DM 患者时，才观察到 HbA1C 与 IENFD 之间存在关联。皮肤活检异常患者的 MetS 特征更为常见，但自主神经功能障碍或符合 SFN 标准的患者中则不然。