Zippenfennig Claudio, Drechsel Tina J, Monteiro Renan L, Sacco Isabel C N, Milani Thomas L
Department of Human Locomotion, Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, 09107 Chemnitz, Germany.
Department of Physical Therapy, Speech and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05360-160, Brazil.
J Clin Med. 2021 Jun 8;10(12):2537. doi: 10.3390/jcm10122537.
Mechanical skin properties (MSPs) and vibration perception thresholds (VPTs) show no relationship in healthy subjects. Similar results were expected when comparing MSP and VPT in individuals with diabetes mellitus (DM) and with diabetic (peripheral-)neuropathy (DPN). A healthy control group (33 CG), 20 DM and 13 DPN participated in this cross-sectional study. DM and DPN were classified by using a fuzzy decision support system. VPTs (in µm) were measured with a modified vibration exciter at two different frequencies (30 and 200 Hz) and locations (heel, first metatarsal head). Skin hardness (durometer readings) and thickness (ultrasound) were measured at the same locations. DPN showed the highest VPTs compared to DM and CG at both frequencies and locations. Skin was harder in DPN compared to CG (heel). No differences were observed in skin thickness. VPTs at 30 and 200 Hz correlated negatively with skin hardness for DPN and with skin thickness for DM, respectively. This means, the harder or thicker the skin, the better the perception of 30 or 200 Hz vibrations. Changes in MSP may compensate the loss of sensitivity up to a certain progression of the disease. However, the influence seems rather small when considering other parameters, such as age.
在健康受试者中，皮肤机械性能（MSP）与振动觉阈值（VPT）之间没有关系。在比较糖尿病（DM）患者和糖尿病（周围）神经病变（DPN）患者的MSP和VPT时，预期会得到类似的结果。一个健康对照组（33名CG）、20名DM患者和13名DPN患者参与了这项横断面研究。DM和DPN通过使用模糊决策支持系统进行分类。使用改良的振动刺激器在两个不同频率（30和200赫兹）和部位（足跟、第一跖骨头）测量VPT（单位为微米）。在相同部位测量皮肤硬度（硬度计读数）和厚度（超声）。在两个频率和部位，与DM和CG相比，DPN的VPT最高。与CG相比，DPN患者的皮肤在足跟处更硬。未观察到皮肤厚度有差异。对于DPN，30和200赫兹时的VPT分别与皮肤硬度呈负相关，对于DM，与皮肤厚度呈负相关。这意味着，皮肤越硬或越厚，对30或200赫兹振动的感知越好。在疾病进展到一定程度之前，MSP的变化可能会补偿敏感性的丧失。然而，考虑到其他参数，如年龄，这种影响似乎相当小。
