Electron Microscopy Unit, Department of Anatomy, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Medicina (Kaunas). 2022 Nov 22;58(12):1696. doi: 10.3390/medicina58121696.
Background: There is a link between diabetic peripheral neuropathy (DPN) progression and the increase in the cross-sectional area (CSA) of the tibial nerve at the ankle. Nevertheless, no prior meta-analysis has been conducted to evaluate its usefulness for the diagnosis of DPN. Methods: We searched Google Scholar, Scopus, and PubMed for potential studies. Studies had to report tibial nerve CSA at the ankle and diabetes status (DM, DPN, or healthy) to be included. A random-effect meta-analysis was applied to calculate pooled tibial nerve CSA and mean differences across the groups. Subgroup and correlational analyses were conducted to study the potential covariates. Results: The analysis of 3295 subjects revealed that tibial nerve CSA was 13.39 mm2 (CI: 10.94−15.85) in DM patients and 15.12 mm2 (CI: 11.76−18.48) in DPN patients. The CSA was 1.93 mm2 (CI: 0.92−2.95, I2 = 98.69%, p < 0.01) larger than DPN-free diabetic patients. The diagnostic criteria of DPN and age were also identified as potential moderators of tibial nerve CSA. Conclusions: Although tibial nerve CSA at the ankle was significantly larger in the DPN patients, its clinical usefulness is limited by the overlap between groups and the inconsistency in the criteria used to diagnose DPN.
糖尿病周围神经病变（DPN）的进展与踝部胫神经横截面积（CSA）的增加之间存在关联。然而，目前尚未有研究对其在 DPN 诊断中的应用价值进行评估。
我们在 Google Scholar、Scopus 和 PubMed 上检索了可能的研究。研究必须报告踝部胫神经 CSA 和糖尿病状态（DM、DPN 或健康）才能纳入。采用随机效应荟萃分析计算各组的平均差异和汇总的胫神经 CSA。进行亚组和相关性分析以研究潜在的协变量。
对 3295 名受试者的分析显示，DM 患者的胫神经 CSA 为 13.39mm2（CI：10.94-15.85），DPN 患者为 15.12mm2（CI：11.76-18.48）。CSA 比无 DPN 的糖尿病患者大 1.93mm2（CI：0.92-2.95，I2 = 98.69%，p < 0.01）。DPN 的诊断标准和年龄也被确定为胫神经 CSA 的潜在调节因素。
尽管 DPN 患者的踝部胫神经 CSA 显著增大，但由于组间重叠和用于诊断 DPN 的标准不一致，其临床应用价值有限。
