糖尿病视网膜病变患者下肢神经病变的相关性及危险因素的临床研究。

A clinical study of the association and risk factors for lower limb neuropathy in patients with diabetic retinopathy.

作者信息

Joshi Devika, Khan Mansur Ali, Singh Anirudh

机构信息

Department of Ophthalmology, Panel Consultant at Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India.

Professor and Head, Department of Ophthalmology, Command Hospital Air Force, Bangalore, Karnataka, India.

出版信息

J Family Med Prim Care. 2020 Apr 30;9(4):1891-1895. doi: 10.4103/jfmpc.jfmpc_231_20. eCollection 2020 Apr.

DOI:10.4103/jfmpc.jfmpc_231_20

PMID:32670936

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7346899/

Abstract

PURPOSE

Association of peripheral neuropathy with diabetic retinopathy is known but the relationship of preclinical neuropathy with various grades of retinopathy is not well documented. This study evaluated the association of preclinical peripheral neuropathy using nerve conduction studies with various grades of retinopathy.

METHODS

Cases of diabetic retinopathy of various grades but asymptomatic for peripheral neuropathy underwent nerve conduction studies of the lower limbs using Caldwell machine and Sierra wave software. The risk factors for retinopathy and association of neuropathy with various grades of retinopathy were analyzed by bivariate and multivariate regression analysis.

RESULTS

The overall prevalence of neuropathy was 75.6% (sensory 58.54% and combined motor and sensory 17.1%) with increase in prevalence with increase in severity of retinopathy. Duration was positively associated with neuropathy (OR = 1.13, 95% CI = 1.02-1.24; = 0.012); moderate nonproliferative diabetic retinopathy (NPDR) (OR = 5.60, = 0.002), severe and very severe NPDR (OR = 5.8, = 0.041), and PDR (OR = 16.05, = 0.000) were significantly at higher risk for having neuropathy as compared to mild NPDR.

CONCLUSION

Duration and severity of retinopathy are important risk factors for peripheral neuropathy. There is a high prevalence of peripheral neuropathy among diabetics with retinopathy especially with severe grades, when neuropathy is diagnosed using nerve conduction studies.

摘要

目的

外周神经病变与糖尿病视网膜病变之间的关联已为人所知，但临床前期神经病变与不同程度视网膜病变之间的关系尚无充分记录。本研究评估了使用神经传导研究的临床前期外周神经病变与不同程度视网膜病变之间的关联。

方法

对不同程度但无外周神经病变症状的糖尿病视网膜病变患者，使用考德威尔仪器和塞拉波软件对其下肢进行神经传导研究。通过双变量和多变量回归分析，分析视网膜病变的危险因素以及神经病变与不同程度视网膜病变的关联。

结果

神经病变的总体患病率为75.6%（感觉神经病变为58.54%，运动和感觉神经联合病变为17.1%），且随着视网膜病变严重程度的增加患病率也增加。病程与神经病变呈正相关（比值比=1.13，95%置信区间=1.02-1.24；P=0.012）；与轻度非增殖性糖尿病视网膜病变（NPDR）相比，中度NPDR（比值比=5.60，P=0.002）、重度和极重度NPDR（比值比=5.8，P=0.041）以及增殖性糖尿病视网膜病变（PDR）（比值比=16.05，P=0.000）发生神经病变的风险显著更高。