Department of Endocrinology and Metabolism. Instituto Nacional de Ciencias, Médicas y Nutrición Salvador Zubirán.
Department of Endocrinology and Metabolism. Instituto Nacional de Ciencias, Médicas y Nutrición Salvador Zubirán.
Endocr Pract. 2021 Jun;27(6):567-570. doi: 10.1016/j.eprac.2021.03.009. Epub 2021 Mar 30.
To examine the performance and agreement of 5 modalities for testing sensory neuropathy against a neurothesiometer among Hispanic patients with type 1 diabetes (T1D) in an outpatient setting.
A cross-sectional study was conducted at a tertiary reference center in Mexico City. Sensitivity, specificity, predictive values, and likelihood ratios were calculated using a VibraTip device, 128 Hz tuning fork, and the Semmes-Weinstein 5.07/10 g monofilament test, Ipswich touch test (IpTT), and pinprick test (PPT). The VPT obtained using a neurothesiometer was used as the standard. Agreement between tests was calculated using kappa coefficients.
Our study included 78 patients (156 examinations), of whom 56.4% were females. The mean age was 38.2 ± 13.0 years, and the mean body mass index was 24.6 ± 4.8 kg/m. The best sensitivity was found for IpTT and VibraTip (89.7% and 79.3%, respectively), while the PPT and IpTT had the highest positive predictive values (94.4% and 92.9%, respectively). The highest kappa coefficients were obtained for the IpTT vs neurothesiometer (kappa coefficient [κ] = 0.893, P < .001), followed by VibraTip vs neurothesiometer (κ = 0.782, P < .001). The VibraTip vs IpTT also had a substantial agreement (κ= 0.713, P < .001).
Our findings demonstrated that the IpTT had the best diagnostic performance and agreement compared with the standard in this cohort of Hispanic patients with T1D. The IpTT is a useful, simple test for diabetic neuropathy screening. These findings support its inclusion in future guidelines for diabetic foot examination.
在一家三级参考中心对门诊就诊的 1 型糖尿病（T1D）西班牙裔患者进行研究，评估 5 种检测感觉神经病变的方法（神经感觉计）与 VibraTip 设备、128 Hz 音叉、Semmes-Weinstein 5.07/10 g 单丝试验、Ipswich 触诊试验（IpTT）和针刺试验（PPT）的性能和一致性。使用神经感觉计获得的 VPT 作为标准。使用 Kappa 系数计算试验之间的一致性。
这是一项在墨西哥城的三级参考中心进行的横断面研究。使用 VibraTip 设备、128 Hz 音叉和 Semmes-Weinstein 5.07/10 g 单丝试验、Ipswich 触诊试验（IpTT）和针刺试验（PPT）分别计算敏感性、特异性、预测值和似然比。使用神经感觉计获得的 VPT 作为标准。使用 Kappa 系数计算试验之间的一致性。
本研究纳入了 78 名患者（156 次检查），其中 56.4%为女性。平均年龄为 38.2±13.0 岁，平均体重指数为 24.6±4.8kg/m。IpTT 和 VibraTip 的敏感性最高（分别为 89.7%和 79.3%），而 PPT 和 IpTT 的阳性预测值最高（分别为 94.4%和 92.9%）。IpTT 与神经感觉计的 Kappa 系数最高（κ=0.893，P<0.001），其次是 VibraTip 与神经感觉计（κ=0.782，P<0.001）。VibraTip 与 IpTT 之间也有显著的一致性（κ=0.713，P<0.001）。
与该 1 型糖尿病西班牙裔患者队列中的标准相比，我们的研究结果表明，IpTT 具有最佳的诊断性能和一致性。IpTT 是一种简单、有用的糖尿病神经病变筛查方法。这些发现支持将其纳入未来的糖尿病足检查指南。
